After positioning the patient, first turn to extirpation of the cystic mass on the right cervical side. Sonographic evidence of a lateral cervical cyst. The palpable mass is well displaceable in levels II to III. Overall obese patient with a short neck, extremely unfavorable anatomical conditions. Skin incision along a skin fold, approx. 2 transverse fingers submandibular. Cut through skin and subcutaneous tissue. Exposure and transection of the platysma. Ample subcutaneous fatty tissue. Partial resection of the fatty tissue. Exposure of the anterior border of the sternocleidomastoid muscle. Here one encounters a cystic mass which appears to lie lateral to the internal jugular vein. Overall cystic mass, but some patchy changes in the mass. Overall neck cyst possible, but not an absolutely typical finding. Successive triggering of the cystic mass. Involvement of surrounding lymphatic tissue. The mass is located directly on the jugular vein and laterally. Circumscribed treatment and exposure of the superior artery. Extirpation of the cystic mass in toto. Careful wound inspection and, if the wound is dry, irrigation with H2O2 and Ringer's solution. Subsequent careful, two-layer wound closure after insertion of an 8-gauge Redon drain. Repositioning for tonsillectomy on the right. Entry with the tonsil retractor. Inspection of the tonsillar lobes. These are symmetrical with cryptic and rather small tonsils. Entering the anterior upper palatal arch. Exposure of the tonsil capsule. Removal of the macroscopically inconspicuous tonsil using the dissection technique. Protection of the parauvular mucosal triangle. Detachment from the posterior palatal arch with careful protection of the musculature and placement at the lower tonsil pole. Targeted treatment of the upper and lower tonsil pole. Final wound inspection if the wound is dry. Completion of the procedure without any indication of complications. Conclusion: Cystic mass on the right cervical side, lateral neck cyst possible. Possible differential diagnoses quite conceivable.