CUPS truly represents the potpourri of oncology.
Diagnosis often follows a complication of metastasis, either from tumor bulk or from functional impairment. Other patients are diagnosed after suspicious lymphadenopathy warrants a biopsy. The patient described below is one in whom the diagnosis was made by lymph node biopsy. The cancer only became symptomatically evident, however, when a large metastasis occluded the small bowel resulting in surgical intervention for palliation of the obstruction. Non-contrast CT showed widespread adenopathy which included cervical, axillary, paratracheal, pretracheal, and subcarinal nodes.