Cecilia
I was Dx'd with an occult (unknown) primary.

My monthly ENT is like Martin, he thinks there was (or is) a primary but it was so small they just couldn't find it.

My Lead RO is like your consultant, He thinks my immune system eliminated it.

My lead surgeon(a H&N guy from our NCI-designated CCC who lead the surgical search) believes it is most likely "aberrant cells, which cannot even be called cancer yet, can metastasize�and form lymph node tumors in the neck, years before such tumors form in the primary site (per speculative finding from MD Anderson and Johns Hopkins research)".

Also, I was told that around 5% of H&N start our as unknowns, but all except about 1% are found when referred to an accredited CCC.

And, for an unknown primary, all of our involved nodes get 60-70gy as do all probable primary sites. Un-involved nodes usually get 50-60gy as do the mucous sites.

We usually get hit hard, but with this protocol, MD Anderson studies show our recurrence is no higher (or lower) than others with known primaries.

So glad to hear Martin is well and got through it OK.