We are proposing a randomized phase II study to assess the benefit of bilateral robot-assisted or laser basal tongue mucosectomy in combination with tonsillectomy in the assessment of prevalent cervical lymphadenopathy

Inclusion Criteria:

• Patient with a prevalent head and neck lymphadenopathy with positive or non-contributory fine needle aspiration, or having had an adenectomy revealing a metastasis of squamous cell carcinoma, a PET examination, an injected cervico-thoracic CT and an ENT work-up (nasofibroscopy) not finding a primary tumor
• Performance Status < 2
• Patient aged 18 or over
• Patient affiliated with social security system
• Informed consent signed

Exclusion Criteria:

• History of squamous cell carcinoma of the VADS or skin of the face.
• History of cervico-facial radiotherapy
• Primary tumor discovering during pan-endoscopy
• Inexposable patient lead not to possible mucosectomy
• Uncontrollable hemostasis disorders (contraindication to tonsillectomy and basic bilateral mucosectomy of language)
• Distant metastases
• Lymphadenopathy inoperable
• Patient with a contraindication to radiotherapy
• Pregnant or breastfeeding woman
• Women of childbearing potential without effective contraception
• Patient under guardianship or unable to give informed consent
• Patient unable to undergo the trial follow-up for geographic, social or psychopathological reasons

tonsillectomy +/- bilateral mucosectomy