The patient had a swelling at the angle of the right jaw approximately 5 weeks ago. This was excised as part of a panendoscopy and lymph node extirpation and sent for histology. This revealed a poorly differentiated squamous cell carcinoma. The patient's history includes a panendoscopy with biopsy of the right tonsil <2010>. The histology at that time showed hyperplastic lymphoepithelial tissue with no evidence of malignancy. Now with confirmed right cervical lymph node metastasis and suspicious findings on one side of the right tonsil, indication for the above-mentioned procedure.