After induction of anesthesia by the anesthesia colleagues, rigid tracheoscopy is performed under laryngoscopic control. This is successful without any problems. Mirroring up to the carina. This is clear on all sides. In the area of the posterior tracheal wall, a small induration or protrusion can be seen paramedian to the left about 5 cm subglottically. This is not exophytic and does not appear primarily suspicious for malignancy. Then problem-free intubation by the surgeon. Positioning by the surgeon. Esophagogastroscopy is performed first. Enter with the gastroscope under laryngoscopic control. Mirroring into the stomach without any problems. Here, food residues are clearly visible, but after aspiration of these, the mucosal conditions are unremarkable on all sides. On endoscopy, clear mucosal changes in the sense of reflux esophagitis are noticeable. Otherwise, however, no exophytic masses. Now enter with the small bore tube. Inspection of the hypopharynx. The hypopharynx is clearly visible up to the esophageal entrance, even the postcricoid region is clear without exophytic masses. No suspicious changes in the area of the base of the tongue, vallecula and epiglottis. Adjustment of the endolarynx. Inconspicuous mucosal conditions without exophytic tumor growth. Inspection of the oral cavity. A coarse, whitish, circumscribed change in the right glossotonsillar groove is seen in the area of the transition to the alveolar ridge anteriorly on the edge of the tongue, the mucosa is slightly reddened and uneven and leads to clearly leukoplakic changes in the area of the edge of the tongue, transitioning to the floor of the mouth, with whitish, non-wipeable coatings. The decision is made to excise the suspicious, indurated mass, which, however, does not move into the base of the tongue on palpation, while at the same time taking the suspicious mucosal changes anteriorly. Now first insert the mouth retractor and mark the resection margins with the electric needle. Dissection with scissors, removing the mucosal changes in the area of the tumorous changes. Removal of the mucosa and the underlying submucosal tissue up to the former tonsil lobe or base of the tongue. All preparation steps under careful hemostasis using bipolar coagulation. The preparation is now marked with sutures. It extends from the right glossotonsillar groove over the alveolar ridge to the anterior third of the right edge of the tongue, passing over to the floor of the mouth. This is followed by thread marking in the anterior (long/long) and lateral (short/short) directions. Representative edge samples are then taken in the area of the anterior edge of the tongue as well as halfway along the area of the floor of the mouth transition and the back of the tongue medially and finally a resection in the area of the cranial tonsil lobe. Then renewed careful inspection and hemostasis using bipolar coagulation. Insertion of hydrogen and Ringer swabs. Meticulous hemostasis. Finally, absolutely dry wound conditions. End of the procedure at this point without any indication of complications.