The patient showed extensive cervical lymph node metastasis, more on the left than on the right, cervically on both sides. A gross needle biopsy of the cervical lymph node metastasis on the left side revealed infiltration by a squamous cell carcinoma. After an unremarkable panendoscopy, a PET-CT was performed, which showed bilateral enhancement in the tonsil region on both sides, which is why a tumor tonsillectomy was indicated.