First bring the patient into the operating room and actively identify the patient. Then carry out the team time-out. Induction of anesthesia and intubation by the anesthesia colleagues. The surgeon now positions the patient. Inspection and palpation of the oral cavity and tongue. As described above, there is a 1 cm large mass on the underside of the tongue on the left anterior side. Furthermore, the papillomatous mass on the glossotonsillar fold on the right side measuring approx. 2 x 1 cm. Directly anterior to this, clearly hyperkeratotic, leukoplakically altered underside of the tongue and tongue surface in the posterior third of the tongue reaching up to the gingiva, which appears suspicious and is directly related to the papillomatous mass. Therefore, excision of the papillomatous mass with the leukoplakic mucosal change in toto. Marking using bipolar. Subsequent excision in toto using a monopolar needle. Several marginal samples are taken (surface of the tongue, undersurface of the tongue, posteriorly and at the base of the wound). Excision of the mass on the anterior underside of the tongue and, after bipolar hemostasis, suturing in this area. After one hour, the frozen section is made: Here, high-grade dysplasia is seen focally in the posterior margin. Therefore, a large incision (2 x 1 cm) is made here and then a marginal sample is sent for final histology. The result is an approx. 5 x 3 cm wound area on the right posterior third of the tongue, soft palate, tonsil lobe and gingiva. Only anterior adaptation of the wound edges using individual Vicryl 3.0 SH sutures. Subsequent bipolar hemostasis and, under dry conditions, completion of the operation without complications. Conclusion: Excision of papillary carcinoma in situ upper and lower posterior tongue, glossotonsillar fold, posterior gingiva and tonsillar lobe on the right with rapid incision in ITN. Excision of a hyperkeratosis on the left anterior side of the underside of the tongue with primary wound closure. Please wait for the final histology, the post-resection and the final margin sample and then present again at our tumor conference.