[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-378508-105":59,"doc-detail-378508-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","carcinoma-of-unknown-primary-cup-an-update-for-histopathologists","Carcinoma of unknown primary (CUP) - an update for histopathologists","","Carcinoma of unknown primary (CUP) is a heterogeneous set of metastatic cancers in which the original site cannot be identified. Poor outcomes stem from late presentation, uncertainty about tumor origin, and treatment delays. This review equips histopathologists with practical diagnostic points to classify and subtype tumors and, when possible, determine the likely primary site. It outlines the oncologist-focused clinical evaluation and the pathologist’s role, including pre-analytical control, sample adequacy, diagnostic pitfalls, and prognostic and predictive biomarker assessment via integrated reporting and molecular tumor board discussion.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/carcinoma-of-unknown-primary-cup-an-update-for-histopathologists/378508/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/carcinoma-of-unknown-primary-cup-an-update-for-histopathologists/378508.png","ImageObject",300,407,{"name":92,"@type":93},"Anna Hans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What defines carcinoma of unknown primary (CUP) and why does it have poor outcomes?","Question",{"text":112,"@type":113},"CUP describes metastatic cancers where the site of origin cannot be identified. Outcomes are poor due to late metastatic presentation, difficulty identifying the origin, and delays in treatment.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What is the pathologist’s main diagnostic objective in suspected CUP?",{"text":117,"@type":113},"The goal is to broadly classify and subtype the cancer and, when possible, confirm the likely primary site, since this information guides treatment and predicts patient outcome.",{"name":119,"@type":110,"acceptedAnswer":120},"How should suspected CUP tissue be processed to maximize diagnostic yield?",{"text":121,"@type":113},"The review recommends embedding the entire biopsy, embedding multiple fragments in separate cassettes, retaining upfront serial spare sections for an immunopanel, and conserving tissue for molecular studies.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},378508,1790921943,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Cancer and Metastasis Reviews (2023) 42:1189–1200 [https://doi.org/10.1007/s10555-023-10101-6](https://doi.org/10.1007/s10555-023-10101-6)  \nCarcinoma of unknown primary (CUP): an update for histopathologists  \nKatie Beauchamp1 · Bruce Moran1 · Timothy O’Brien2 · Donal Brennan3,4 · John Crown5 · Kieran Sheahan1 · Maura Bríd Cotter1  \nReceived: 18 January 2023 / Accepted: 3 April 2023 / Published online: 3 July 2023 © The Author(s) 2023  \nAbstract  \nCarcinoma of unknown primary (CUP) is a heterogeneous group of metastatic cancers in which the site of origin is not identifiable. These carcinomas have a poor outcome due to their late presentation with metastatic disease, difficulty in identifying the origin and delay in treatment. The aim of the pathologist is to broadly classify and subtype the cancer and, where possible, to confirm the likely primary site as this information best predicts patient outcome and guides treatment. In this review, we provide histopathologists with diagnostic practice points which contribute to identifying the primary origin in such cases. We present the current clinical evaluation and management from the point of view of the oncologist. We discuss the role of the pathologist in the diagnostic pathway including the control of pre-analytical conditions, assessment of sample adequacy, diagnosis of cancer including diagnostic pitfalls, and evaluation of prognostic and predictive markers. An integrated diagnostic report is ideal in cases of CUP, with results discussed at a forum such as a molecular tumour board and matched with targeted treatment. This highly specialized evolving area ultimately leads to personalized oncology and potentially improved outcomes for patients.  \nKeywords Carcinoma of unknown primary · Metastatic · Morphology · Pitfalls · Immunohistochemistry · Molecular pathology  \n1 Introduction  \nThe majority of patients with cancer present with a clearly defined primary malignancy that manifests with typical local or metastatic symptoms. However, 10–15% present with metastatic disease from the outset rather than with a primary tumour. In about two-thirds of these, the primary site is identified during clinical investigation or over time; however, in the remaining third, the primary site is never  \n* Katie Beauchamp katie.beauchamp@hse.ie  \n1 Department of Histopathology, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland  \n2 Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin 7, Ireland  \n3 Systems Biology Ireland, UCD School of Medicine, Belfield, Dublin4, Ireland  \n4 UCD Gynaecological Oncology Group, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland  \n5 Department of Medical Oncology, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland  \nfound, termed carcinoma of unknown primary origin (CUP)[1, 2] . CUP represents a morphological, immunohistochemical and molecular diagnostic challenge in surgical pathology. In this review targeted at histopathologists, we provide practical diagnostic practice points. We also recognize that the current oncological paradigm is focussed on the therapeutic options available to CUP patients. Increasingly, this involves the use of predictive biomarkers using additional immunohistochemistry and molecular assays beyond those traditionally used to detect the primary site.  \n2 Tissue processing and histopathology review  \nInitial clinical presentation varies depending on the organs involved by metastatic disease, and therefore tissue samples may be submitted from any anatomic site in a case of suspected CUP, including endoscopic biopsies, small CT/ ultrasound-guided biopsies, and even smaller cytology samples. One of the main challenges pathologists face today is that samples are becoming less and less invasive resulting in  \nsmaller specimens. At the same time, advances in therapeutics have led to increased numbers and complexity of tests required from the same piece of tissue including biomarkers for","cbCaihLe3Qg3mzhX","https://ap.wps.com/l/cbCaihLe3Qg3mzhX","pdf",1934821,12,"English","# Abstract\n# Introduction\n# Tissue processing and histopathology review\n## Embedding and specimen handling\n## Assessing tumor content and necrosis\n## Morphological analysis and limited immunohistochemistry","[{\"question\":\"What defines carcinoma of unknown primary (CUP) and why does it have poor outcomes?\",\"answer\":\"CUP describes metastatic cancers where the site of origin cannot be identified. Outcomes are poor due to late metastatic presentation, difficulty identifying the origin, and delays in treatment.\"},{\"question\":\"What is the pathologist’s main diagnostic objective in suspected CUP?\",\"answer\":\"The goal is to broadly classify and subtype the cancer and, when possible, confirm the likely primary site, since this information guides treatment and predicts patient outcome.\"},{\"question\":\"How should suspected CUP tissue be processed to maximize diagnostic yield?\",\"answer\":\"The review recommends embedding the entire biopsy, embedding multiple fragments in separate cassettes, retaining upfront serial spare sections for an immunopanel, and conserving tissue for molecular studies.\"}]","Carcinoma of unknown primary (CUP) - an update for histopathologists | PDF",1790230375]