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Background and Objectives:Cervical metastasis of unknown origin (MUO) comprises 3- 5% of all head and neck malignancy. is study was to evaluate diagnostic aproaches to detect the primary site in patients with neck mas of metastatic squamous cel carcinoma and analyze treatment modalities and their outcomes as well. Subjects and Method:Of 710 patients who had been diagnosed with squamous cel carcinoma of the head and neck site from Jan. 1992 through Dec. 2005, 73 patients were refered to or visited our clinic regarding the presence of neck mas. With retrospective review of the medical record, the diagnostic appro-ents and outcomes. Results:The diagnostic steps that revealed the primary sites were as folows:physical examination in 29 cases (39.7%), conventional imaging (CT or MRI) in 5 cases (6.8%), PET scan in 1 case (1.4%), OPD based directed biopsy in 3 cases (4.1%), and intraoperative directed biopsy in 5 cases (6.8%). Primary sites were not detected in 30 cases (41.1%)remission was obtained in 24 patients, for whom 5-year disease free survival rate was 62.1%. Conclusion:Thorough physical examination and directed biopsy are strongly recomended for the diagnosis of MUO, but the diagnostic value of PET scan needs to be folowed up with more cases. (Korean J Otorhinolaryngol-Head Neck Surg 207 ;50 :1125-9)

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