ABSTRACT
Squamous cell carcinoma of supraglottis is a common head and neck malignancy, comprising 30% of laryngeal carcinoma. Supraglottic carcinoma commonly metastasizes to the Levels II, III, and IV cervical nodes, and distant metastases are uncommon. Delayed local and regional recurrences are known, local recurrence being more common. We report a case of carcinoma supraglottis with the advanced locoregional disease at initial presentation and treated with neoadjuvant chemotherapy followed by chemoradiotherapy with a complete response on post-treatment positron emission tomography-computed tomography (PET-CT) scan. Surveillance PET-CT showed an isolated lesion in the left post-styloid parapharyngeal space, where neurogenic tumors are more common and isolated nodal metastasis is unusual. We did ultrasound-guided FNAC and cytology confirmed the presence of metastatic poorly differentiated carcinoma.