What is primary site of metastasis for stage IV squamous cell carcinoma?
Patient: Hi, may I answer your health queries right now ?  Please type your query here... Hello,  my brother has stage iv squamous cell carcinoma, primary is unknown.  He is having surgery on his neck to remove the tumor and send to pathology for further testing and I guess to find the primary site of his metastasis.  What should I expect?  I have some medical knowledge.  Thank you Doctor: hi ...it can be an unknown primary with secondaries in neck. you should ideally go for a PET scan to locate the site of primary which is the best investigation. however if you cant spend that much,you should visit an ENT surgeon to get a panendoscopy (esophagoscopy,nasal endoscopy, DL scopy,bronchoscopy ) done to assess all the primary sites of cancer.you will also have to undergo blind biopsies from sites like nasopharynx and tonsillectomy which are the sites for hidden carcinoma.squamous cell carcinoma mean it will be mostly from head and neck region especially nasopharynx or oral cavity or upper GI tract.if you get evaluated in a manner the way I told you will definitely get the primary site.all the best.