You do understand that you can have SCC in your mouth and it can not be visible, ie. occult, meaning buried in the tissues of the tonsil perhaps, looking totally normal (absent)to examiners. At that size it can also be missed by scanning technologies that typically look at slices that are about 5mm between each view. So the unknown primary issue, many times is just occult, not unknown. The Hopkins experience on consecutive patients with positive cervical nodes and occult oral environments found just this. 70% of them had a small 2mm primary buried deep in the tonsil when those normal looking tonsils were excised and biopsied. This is occult, not absent. And there is no argument that SCC has to originate from squamous tissues, and the closest ones to the neck are in the mouth, that is a forgone conclusion. I don't get what people don't get about all this in this post.

Sorry, but I'm out of this conversation.

Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.