In the patient, a cT3 cN1 G3 oropharyngeal carcinoma on the left was evaluated as part of a panendoscopy on <2013>, which had already been histologically confirmed externally. The patient was also found to have CLL with manifestations in the vallecula area. However, no further measures were required here. In our interdisciplinary tumor conference, primary surgical treatment was indicated. Preoperative sonography revealed a neck status of at least cN2b on the left side with conspicuous nodules in level Ia. After radial artery harvesting in the area of the left forearm, there were limited possibilities for graft harvesting.