In the patient, a cT1 hypopharyngeal carcinoma on the right was histologically confirmed during a panendoscopy <2014>, with initial signs of CUP syndrome with right cervical lymph node metastasis. In our interdisciplinary tumor conference, the primary surgical procedure was recommended. CT diagnostics showed the primary tumor to be poorly defined in the area of the right piriform sinus. There was also an unclear change in the right tonsil. The most recent ultrasound showed a cN1 neck status on the right.