These images show asymmetric enlargement of the right palatine tonsil abutting the posterior aspect of the soft palate and right aspect of the uvula which may be secondarily involved by the mass. There are centrally necrotic right neck level IB and IIA enlarged lymph nodes compatible with metastasis as seen in HPV-related squamous cell carcinoma. The palatine tonsil is the most common subsite of oropharyngeal squamous cell carcinoma. 75% have adenopathy at presentation as seen in this case. HPV cancers are generally seen in younger patients and have a more favorable prognosis.