Oh David. She should have screamed "you're a man"... it seems it takes you guys a little while to mention it and get to the doctor to have it checked out. Not to say that the entire gender is idiotic. I think the distinction of "idiot" should be applied on an individual basis. From what I've read, you are no idiot but you definitely are a man. But then again, wives tend to know their husbands better than anyone else...okay, I'll quit while I'm behind.

Back to the question....

When J was diagnosed (misdiagnosed?), it was based on a lymph node biopsy because he had no noticeable tumor. J (who waited 9 months to go to the doctor) presented with a swollen node on the left side of his neck. The FNA was negative. But the excisional BX, we were told, was positive. (It is my thought that the misdiagnosis stemmed from a positive p16 for HPV and a cyst that tends to look like SCC.)

The positive DX for SCC HN led to a diagnostic tonsillectomy and random oral cavity BX's which were all negative. No primary tumor was located. And, since squamous cells do not appear in lymph nodes unless it is either a metastases from a primary tumor of squamous origin or is a branchial cleft cyst, the cancer did not originate in the lymph node. So, it was assumed that J's tumor either "resolved" on its own or it was too small to be detected. The only other diagnostic option is to have J undergo microsurgical biopsies of his BOT and what is left of his tonsil area. There is still a strong possibility that the primary won't be found.

Let me reiterate--J never had any other symptom besides the swollen spot on his neck. There was no pain, there wasn't any difficulty talking, eating, breathing, etc. Nothing. Nothing appeared abnormal when the ENT scoped him. His labs were normal. In fact, the ENT did not have any feeling that it was cancer. He was shocked when the path report came back positive. But, this pattern is widely recognized as within the realm of normal for HPV related SCC HN. The path at the CCC where J had his slides evaluated also said as much...but, they DX'd a BCC not an SCC.

Since his BX, J has no swelling and no discomfort. Just lots of anger that he had major surgery, teeth pulled, radiation, chemo, and the scare of his life presumably for nothing. He'll get an updated DX soon.

Curiously, J's ENT mentioned that the pathologist suggested it could be lymphoma...!...scary. I'm sure you all know lymphoma comes from lymph cells. SCC comes from squamous cells. Kittens come from cats. You get my point. Both the ENT and I were mystified by what the pathologist said. I was not a bit confident in his abilities from that day forward.