Background: Only about 1% of all head and neck lateral or paramedian cancers described in the scientific literature shows, in staging, contralateral cervical adenopathy without ipsilateral pathological involvement of lymph nodes.
Case presentation: This case is one of them, in which 18F-FDG PET/CT scan is confirmed by pathology findings, and has correctly identified all metastatic disease foci.
Conclusions: To date, PET/CT is not recommended in head and neck cancer staging. However, the use of PET/CT in head and neck cancer staging can define possible metastatic disease foci, clarify c.e. CT suspicious findings and, in some cases, change the TNM stage, with a strong prognostic and therapeutic impact.