Background: Parotid lymph node (LN) metastasis occurs most frequently from squamous cell carcinoma (SCC) of the head and neck. In SCC of the head and neck, metastatic involvement of the parotid gland is associated with a poor prognosis but the parotid LN remains an uncommon site of metastasis for oral squamous cell carcinoma. The management of tongue carcinoma is primarily surgical, with radiation also having an important role mainly in advanced disease, poor surgical candidates, unresectable disease, and importantly, as an adjuvant to surgery in some cases. Unless there is a clear contraindication for surgery or the tumor is unresectable, surgery should be offered as primary treatment for tongue squamous cell carcinoma.