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Offline Sree_v

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« on: April 08, 2012, 10:23:09 AM »
role of the FNAC in secondaries of the neck with occult primary.  slide

Offline Dr.Habiib

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« Reply #1 on: April 10, 2012, 01:02:29 AM »
Occult primary:

It is present by neck mass without finding of primary tumor.
It will be very dangerous to take any intervention before discovering the origin of this tumor (cancer).
So there is role when you are dealing with cancer case, it is  totally different  from all other cases in the clinical, you must be know well and put  your investigation in right way, otherwise you nothing at all.
Missing one case of cancer that can safe will cause you loss of conscious for future time, so be carefully in cases tumors and be honest to save the people.

Any intervention, surgical removal or biopsy is absolute contraindicated in occult primary.

Because all intervention surgical removal or biopsy has following drawbacks:
1. Spillage of malignant cells.
2. False sense of security for the patient that he is very from disease, although the tumor is present still.
3. If the mass proved to be squamous cell carcinoma, it is not indicate the site of primary tumor, as most of primary tumors of head and neck are squamous cell carcinoma.
4. Your incision will interfere with the incision of radical neck dissection later on.

So the only way that we get pathological sample from occult primary is Fine Needle Aspiration Biopsy (FNAB), that it is role in primary occult.

Ethical principles of medical professionalism:
1. Beneficence: to do good to patient.
2. Non maleficence: not to harm the patient.
3. Justice: to be fair to all patients.
4. Respect for autonomy: free decision for the patient