Early stage squamous cell carcinoma of the tonsil presenting with multiple organ metastases including skin and brain after successful local treatment

Early stage carcinoma of the tonsil is curable,and the incidence of systemic metastasis is very low and central nervous system involvement is very rare.A patient diagnosed with early stage tonsillar carcinoma treated with chemoradiation was followed by brachytherapy boost.One and half years after completion of treatment,the patient presented with disseminated metastasis to the skin,lung,liver,bone,and brain.He had all favorable prognostic parameters except being a young adult.