We analyzed 7 patients with so called "maligne lateral cervical cysts" regarding the controversies in the literature. Primary tumors of oropharyngeal sites were discovered in all these cases of "branchiogenic carcinoma" rising the final diagnosis of cystic metastases. Diagnostic tonsillectomy is supposed to be important to solve this problem of differential diagnosis. The issue of malignant transformation in cysts of branchial cleft origin has to be recognized as being an oncological artifact. We argue that the "maligne lateral cervical cyst" does'nt exist as a proper entity. In analogy to the principles of the treatment of oropharyngeal cancer ipsilateral neck dissection and wide local excision of the cyst followed by radiation therapy is the suggested plan of therapeutic management. Search for a possible unknown primary tumor within the oropharynx must be continued over years.