History of progressive left cervical lymph node since <2011>. External bioptic histological confirmation of a moderately differentiated keratinized squamous cell carcinoma. Acceptance of the externally performed computed tomography, it showed a restless mucosa in the area of the left palatal arch up to the entrance into the left piriform sinus. However, there was no evidence of a primary tumor in the area of the left tonsillar lobe on endoscopy. In summary of the findings, a left cervical CUP syndrome is now suspected. There is now an indication for panendoscopy, including biopsy and PEG placement if necessary. If the intraoperative findings were unremarkable, a CUP panendoscopy was also discussed in consultation with the patient. The patient had ample opportunity to ask questions about the procedure explained.