Abstract
We have treated three cases of neck squamous cell carcinomas with an unknown primary. After more than two years, the palatine and the lingual tonsils were identified as the primary sites metastatic to the neck by tonsillectomy and biopsy, respectively, in two of the patients. In both of these cases, the primary sites and neck metastatic nodes were HPV-positive. One case showed a cystic metastatic lymph node. The remaining case was still considered to have neck squamous cell carcinoma with an unknown primary after more than five years and was HPV-negative. A thorough investigation of oropharyngeal sites, specifically the palatine tonsils and the lingual tonsils, should be performed in patients with cystic metastasis to the neck from an unknown primary tumor and/or HPV-positive cancer with an unknown primary.
