Cancer of unknown primary (CUP) defines a heterogeneous group of metastatic tumors that lack an identifiable primary tumor, despite a standardized diagnostic work-up (Fizaziet al, 2015).CUPs are characterized by an aggressive clinical course, unusual metastatic pattern, and poor prognosis. Research in this field has been encouraged to unravel the complexity of this enigmatic entity and improve clinical management and survival ofCUPpatients. In this issue ofEMBO Molecular Medicine, Benvenutiet al(2020) describe the molecular characterization of multiple synchronous and spatially distinct metastases from aCUPpatient, shedding light on the evolutionary dynamic and distinctive features ofCUP.
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