{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T00:20:31Z","timestamp":1705710031434},"reference-count":29,"publisher":"Harborside Press, LLC","issue":"1D","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>This report presents the case of a 62-year-old woman who was diagnosed in 1999 with stage I cervical carcinoma treated by surgical resection. In 2021, she presented to the emergency department with a complaint of predominantly right-sided lower back pain. A CT scan of the lumbosacral region revealed a bone lesion in the L5 vertebra and retroperitoneal lymphadenopathies suggestive of malignancy. Histology of the L5 vertebra biopsy showed a poorly differentiated carcinoma with an inconclusive immunophenotypic profile. Treatment for carcinoma of unknown primary was started with a combination of carboplatin and paclitaxel every 21 days. A genomic study of the biopsy specimen performed on the FoundationOne CDx platform identified a nonhuman genetic signature compatible with HPV. The presence of HPV 18 DNA in the specimen was confirmed by PCR-reverse dot blot, and the immunophenotypic profile was expanded, revealing strong and diffuse p16 expression, thus corroborating the molecular findings. In view of these findings, the case was reclassified as a recurrence of the cervical adenocarcinoma that had been diagnosed and treated 23 years earlier. Based on the new results, and according to first-line cervical carcinoma protocols, bevacizumab at 15 mg\/kg every 21 days was added to her chemotherapy regimen. The identification of HPV DNA sequences by next-generation sequencing facilitated the correct diagnosis and led to a modification of the first-line therapeutic approach.<\/jats:p>","DOI":"10.6004\/jnccn.2023.7079","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T15:06:54Z","timestamp":1703689614000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the Identification of Nonhuman Genetic Signatures in the Diagnosis and Management of Carcinoma of Unknown Primary"],"prefix":"10.6004","volume":"22","author":[{"given":"Arantzazu","family":"Barqu\u00edn Garc\u00eda","sequence":"first","affiliation":[{"name":"Gynecological, Genitourinary, and Skin Cancer Unit, HM CIOCC Madrid (Centro Integral Oncol\u00f3gico Clara Campal), Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain"},{"name":"Institute of Applied Molecular Medicine (IMMA), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Urbanizaci\u00f3n Montepr\u00edncipe, Madrid, Spain"},{"name":"Institute of Applied Molecular Medicine (IMMA), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Urbanizaci\u00f3n Montepr\u00edncipe, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Palacios-Zambrano","sequence":"additional","affiliation":[{"name":"Department of Pathology-Therapeutic Target Laboratory, Hospital Universitario HM Sanchinarro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Lozano Alarc\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Pathology-Therapeutic Target Laboratory, Hospital Universitario HM Sanchinarro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Paumard-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Laboratorio de Gen\u00e9tica Molecular AbaCid, Hospital Universitario HM Sanchinarro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Quiralte Pulido","sequence":"additional","affiliation":[{"name":"Gynecological, Genitourinary, and Skin Cancer Unit, HM CIOCC Madrid (Centro Integral Oncol\u00f3gico Clara Campal), Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain"},{"name":"Institute of Applied Molecular Medicine (IMMA), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Urbanizaci\u00f3n Montepr\u00edncipe, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paloma","family":"Navarro","sequence":"additional","affiliation":[{"name":"Gynecological, Genitourinary, and Skin Cancer Unit, HM CIOCC Madrid (Centro Integral Oncol\u00f3gico Clara Campal), Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain"},{"name":"Institute of Applied Molecular Medicine (IMMA), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Urbanizaci\u00f3n Montepr\u00edncipe, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Laboratorio de Gen\u00e9tica Molecular AbaCid, Hospital Universitario HM Sanchinarro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Salas Villar","sequence":"additional","affiliation":[{"name":"Department of Pathology-Therapeutic Target Laboratory, Hospital Universitario HM Sanchinarro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Garc\u00eda-Donas","sequence":"additional","affiliation":[{"name":"Gynecological, Genitourinary, and Skin Cancer Unit, HM CIOCC Madrid (Centro Integral Oncol\u00f3gico Clara Campal), Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain"},{"name":"Institute of Applied Molecular Medicine (IMMA), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Urbanizaci\u00f3n Montepr\u00edncipe, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4047","reference":[{"key":"B1","series-title":"Nature","first-page":"687","article-title":"Nucleotide sequence of bacteriophage phi X174 DNA","volume":"265","author":"Sanger F","year":"1977","unstructured":"Sanger F, Air GM, Barrell BG,  Nucleotide sequence of bacteriophage phi X174 DNA. 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