After problem-free induction of anesthesia by the anesthesia colleagues, a rigid tracheoscopy is performed first. For this purpose, an O° scope was inserted and the trachea inspected, which was free, non-irritated and clearly visible up to the carina. Finally, withdrawal of the rigid endoscope if there is no evidence of an exophytically growing mass. Removal of the endoscope and intubation by the surgeon. The patient's head is then placed in a low position and a flexible esophagogastroscopy is performed. For this, a flexible endoscope is inserted into the stomach under visualization. A regular mucosal relief can be seen in the stomach. The endoscope is advanced as far as the pylorus, where conditions are also unremarkable. Then carefully withdraw the flexible endoscope and inspect the esophago-gastric junction. Discrete signs of chronic reflux esophagitis. However, no evidence of an exophytic or ulcerating mass. Then careful withdrawal of the flexible endoscope and inspection of the esophagus, here as far as possible inconspicuous mucosal conditions. Then remove the flexible endoscope, insert a mouth guard and perform a pharyngo- and laryngoscopy. For this purpose, a Kleinsasser C-tube is inserted and the oral cavity region, the floor of the mouth and the upper pharyngeal sections are inspected. A slightly spherical and broad-based, rough mass approx. 1 x 1 cm on the median underside of the tongue sitting directly on the frenulum lingulae, which also shows a cone-shaped extension towards the carunculae. The rest of the floor of the mouth as well as the tongue, oral vestibule, tonsillar lobes, palatal arches and uvula are intact and without irritation. The deeper pharynx with the posterior pharyngeal wall region, the piriform sinus entrances and hypopharyngeal walls on both sides are also unremarkable and without irritation. The arytenoid region, aryepiglottic fold and epiglottis are also non-irritant and inconspicuous. The glottis itself is also non-irritating and inconspicuous. Then removal of the Kleinsasser C-tube and the mouth guard and finally turning to the tumorous mass. First demonstration of findings on <CLINICIAN_NAME>. First, an anterior duct incision of the wharton's duct is performed on both sides after the tumor reaches the caruculae with an extension. The duct is slit on both sides without any problems. The slit duct section is marsupialized. The mass is then successively removed in toto with the scissors with a sufficiently wide safety margin and bipolar coagulation of the feeding vessels. The marsupialized duct tissue is spared. The preparation is then thread-marked for final histology. Extensive hemostasis by means of bipolar coagulation with absolutely dry wound conditions, then termination of the procedure with repositioning of the patient's head. Summarizing remarks: During the operation, a panendoscopy was performed with unremarkable findings and an excision in toto of the already confirmed squamous cell carcinoma on the underside of the tongue. In addition, an anterior duct incision of the wharton's duct was performed on both sides. The patient was advised to undergo intensive gland massage postoperatively. Waiting for the definitive histology, if necessary resection and initially further thyroid clarification by means of a scintigraphy before planning a coarse needle biopsy.