The patient had already been diagnosed with cT4a and cN2b transglottic laryngeal carcinoma in 2010. Had resisted therapy in the further course. Now in 2012, the patient presented again in an emergency when intubation by the emergency physician was impossible due to asphyxia. A new panendoscopy was performed as part of the retracheotomy. This revealed an extensive laryngeal carcinoma, which was confirmed by biopsy to be a poorly differentiated squamous cell carcinoma. The CT scan performed showed a cT4a laryngeal carcinoma on the right side with extensive destruction of the thyroid cartilage and extensive extralaryngeal growth, but no evidence of infiltration of vascular or mediastinal structures. There was also no evidence of distant metastasis, which is why the indication for surgical treatment was given, given the patient's desire for treatment.