Head and neck carcinoma of unknown primary (HNCUP) signifies a challenging diagnostic process with serial investigations that can often fail to identify the primary tumor site.
1 This clinical scenario is increasingly encountered in view of the human papilloma virus (HPV) epidemic posing major healthcare challenges. Prior to the introduction of transoral robotic surgery (TORS), the work-up for HNCUP provided an estimated tumor detection rate of around 50% and included a variety of radiological and surgical procedures such as panendoscopy of the upper aerodigestive tract, biopsies, and tonsillectomy.
2 This relatively low detection rate led to treatment with wide radiotherapy fields that inevitably contributed to increased patient morbidity including dysphagia, xerostomia and lymphedema.
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