In the patient, a cT2 cN2a oropharyngeal carcinoma on the right was confirmed during a panendoscopy. CT imaging showed a large lymph node metastasis measuring at least 4 cm in level II on the right, which was relatively close to the primary, in the tonsil region with a circumscribed transition to the base of the tongue. In addition, further conspicuous lymph nodes in level II on CT, therefore a cN2b neck status. No evidence of distant metastases. Indication for primary surgical treatment, in case of extensive defect also indication for defect coverage by radial artery graft.