Metastatic squamous cell carcinoma of the tonsil presenting as multiple cystic neck masses. Report of a case with fine needle aspiration findings.

A case of squamous cell carcinoma with multiple cystic metastases to the neck is reported. The tumor originally presented as a tender left neck mass clinically misdiagnosed as an abscess secondary to infected dental caries. Subsequently, multiple cervical neck cysts developed, and fine needle aspiration (FNA) of two of them demonstrated metastatic squamous cell carcinoma. A tonsillar primary was found. Metastatic squamous carcinoma of the tonsil often presents as a solitary neck cyst that may be confused with a benign lesion. On FNA the lesion must be distinguished from branchial cleft cyst and Warthin's tumor with squamous metaplasia.