In the patient, a cT2 cN3 cM0 G3 oropharyngeal carcinoma on the right was histologically confirmed as part of a panendoscopy. Due to the extensive metastasis, the CT scan showed the internal carotid artery to be displaced over a long distance, and an occlusion test was carried out preoperatively if there was no reliable sonographic infiltration. This revealed no discernible infiltration of the right internal carotid artery and normal occlusion with good collateralization. In our interdisciplinary tumor conference, primary surgical treatment was indicated.