Presented are two cases of simultaneous occurrence of epithelioid granulomas and metastatic squamous cell carcinoma in cervical lymph nodes draining supraglottic carcinoma. Laboratory tests and radiological and clinical findings ruled out sarcoidosis, as well as mycotic, mycobacterial, or other bacterial infection. Upon finding of epithelioid granulomas in cervical lymph nodes, a malignant tumor of the head and neck region should be considered as a differential diagnostic possibility. Uncritical acceptance of a diagnosis based solely on the histological appearance may lead to erroneous treatment.