Cystic nodal metastasis in occult tonsil carcinoma--a case report.

A "branchial cyst" in a patient above 40 years old may turn out to be a malignant cystic nodal metastasis from a primary tumour in the tonsil. We present a case of a 45-year-old woman in whom an initial mistaken diagnosis of branchial cyst was made. The neck mass was discovered to be malignant and the left tonsil was subsequently implicated as the primary source. Older patients with cystic neck masses should be managed on the presumption that these may possibly be metastatic lesions from a primary oropharyngeal tumour.