The work around is to get a second biopsy done and specify where you want it sent, picking the institution that you want. I forget the history here, did he have his tonsils removed for the biopsy, or did they take a sample of them? If he had a positive node for SCC, then he needs to go through the treatments even with an occult oral environment. HPV+ oral cancers are frequently occult and can be as small a primary as 2-3mm inside a tonsil or base of tongue tissue. At that size it could easily be missed in a CT scan. At that size they spin off SCC daughter cells which move into the neck through the normal lymph drainage passageways, rather quickly before the primary has had a chance to grow to a significant size. There would be nothing on the surface to see. This is a very common presentation of HPV+ oral cancers.