The patient's right tonsillar carcinoma was histologically confirmed during a panendoscopy on <2013>, and a simultaneous oropharyngeal carcinoma on the left in the area of the caudal tonsil pole was also diagnosed during the panendoscopy. In our interdisciplinary tumor conference, primary surgical treatment was indicated. Immediate preoperative sonographic cN2b neck status on the left, computed tomographic cT2 tonsillar carcinoma on the right. The simultaneous small oropharyngeal carcinoma could not be visualized by computed tomography.