A cT4a cN0 hypopharyngeal carcinoma was confirmed in the patient during an emergency panendoscopy with tracheotomy. Emergency intervention already <2012>. <2012> the panendoscopy was performed to plan the surgical procedure and the PEG was placed. CT scan and clinically extensive laryngeal destruction with extensive growth per continuitatem in the soft tissues of the neck on the left. The multimorbid patient has a pronounced peripheral arterial occlusive disease with a history of leg amputation on both sides.