Squamous cell carcinoma of the base of tongue with initial presentation of cystic metastasis in contralateral cervical lymph node

A case of squamous cell carcinoma of the base of tongue presenting initially as a cystic metastasis in the contralateral neck is described. The patient complained of a painless mass in the left neck, which was removed and histologically diagnosed as cystic malignancy. One year and seven months after the removal, a squamous cell carcinoma of the right tongue base and cystic metastases of the right neck were discovered. The histologic similarity among these three lesions strongly indicated the cystic metastases in the bilateral neck were from the squamous cell carcinoma of the tongue base.