76-year-old man with a rapidly growing mass on angle of jaw. Fine needle aspiration on 12/6/16 diagnosed squamous cell carcinoma. The presumptive primary carcinoma was skin. On 12/16/16, the patient underwent a left parotidectomy and cervical lymphadenectomy. Pathology showed multiple lymph node involvement. Radiation and concurrent chemotherapy treatment began on 1/18/2017 and was completed on 2/6/2017. CT/PET on 6/6/2017 showed evidence of recurrent hypermetabolic foci.