Proposta de algoritmo diagnóstico para o carcinoma epidermoide da cabeça e pescoço com tumor primário desconhecido: uma abordagem baseada na evidência
DOI:
https://doi.org/10.34631/sporl.3154Palavras-chave:
Cancro cabeça e pescoço, carcinoma epidermoide, Tumor primário ocultoResumo
Objetivos: Construção de um algoritmo de abordagem diagnóstica para aplicar nos casos de carcinoma epidermóide da cabeça e pescoço com tumor primário desconhecido.
Material e Métodos: Foi realizada uma revisão narrativa da literatura nas bases de dados PubMed e Scopus em junho de 2025, focada em estudos sobre a abordagem diagnóstica do carcinoma epidermoide da cabeça e pescoço com tumor primário desconhecido.
Resultados: O protocolo proposto inicia-se com uma estratificação vírica através da pesquisa de p16 e EBER na biópsia da adenopatia, seguida de uma abordagem diagnóstica sequencial guiada por estes resultados, integrando uma avaliação imagiológica funcional com PET-TC antes da realização de biópsias de locais suspeitos. Nos casos com EBER negativo, é recomendada uma exploração cirúrgica sistemática do trato aerodigestivo superior, que, na ausência de lesões suspeitas, deve ser complementada com amigdalectomia total bilateral e mucosectomia ipsilateral da base da língua. Nos casos com EBER positivo, o foco diagnóstico é dirigido para a nasofaringe, sendo recomendada avaliação imagiológica com ressonância magnética.
Conclusões: Uma abordagem sistematizada nos casos de carcinoma epidermoide em adenopatias cervicais com tumor primário desconhecido poderá permitir uma melhor utilização dos recursos atualmente disponíveis e aumentar a taxa de identificação do tumor primário.
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Direitos de Autor (c) 2026 Diogo Cunha-Cabral, Pedro Marques Gomes, José Pedro Pereira, André Alves Carção, Nuno Oliveira, Marta Vilaça, Gustavo Lopes, José Ferreira Penêda
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-CompartilhaIgual 4.0.
