Induction of anesthesia and intubation by the anesthesia colleagues. Then entry with the Mc Ivor oral spatula and inspection of the tonsil on the right side. An ulcer-like mass was found in the area of the right tonsil, with mucosal changes on the anterior and posterior palatal arches and superficial mucosal changes, even just to the parauvular level. The tumor was then cut around with a safety margin of 0.5 to 1 cm using a monopolar needle. In depth, the tumor must be dissected with bipolar forceps and scissors. In the area of the cranial tonsil pole, the resection extends into the soft tissues of the neck. Neck fat is revealed, then the entire tumor preparation is removed en bloc and deposited at the base of the tongue. The specimen is placed on cork for frozen section. In the area of the cranial tonsil pole, a resection specimen is taken, as the resection margins appear to be very narrow here. This is also thread-marked and placed on cork for a frozen section. Then take a margin sample from the depth in the area of the deepest resection site. In the frozen section all marginal samples are R0, in the area of the median margin of the posterior pharyngeal wall there is still at least moderate dysplasia and in consultation with the pathology department this should be resected again. Therefore, a strip of mucosa is removed here again, which is thread-marked (remote from the tumor) for final histology. During the frozen section break, a PEG was inserted with good diaphanoscopy and without complications. Please plan a second neck dissection on both sides and then present at the tumor conference.