After induction of anesthesia, head positioning and entering with the small water tube. Re-inspection of the tumor region. The tumor extends in the posterior third of the edge of the tongue, extends to the base of the tongue, the glossotonsillar groove and the alveolar ridge, but is displaceable in relation to these. Now insertion of the retractors. Place a retaining thread and pull out the tongue. Establish the resection margins with a sufficient safety margin around the tumor. Now successive dissection of the tumor, taking the right palatine tonsil with it. Careful protection of the right posterior palatal arch, the lingual nerve, the lingual fibers of the hypoglossal nerve and the Wharton's duct. Excision of the tumor with sufficient safety margin in toto. The specimen is thread-marked for frozen section diagnostics. Careful hemostasis using bipolar coagulation. In the frozen section, the tumor is found to be R0 resected, but the specimen shows a carcinoma in situ that is probably not connected to the tumor and reaches the edge of the palatal arch. Before resecting the tumor, the patient was first examined with an esophagogastroscope. Pre-viewing to the stomach and placement of the PEG tube using the thread pull-through method in the typical manner, after positive diaphanoscopy. Now turn first to neck dissection on the right. After skin disinfection, infiltration anesthesia with Ultracaine with added adrenaline. Skin incision on the anterior border of the sternocleidomastoid muscle. Exposure of the anterior border of the sternocleidomastoid muscle. Exposure of the omohyoid muscle. Exposure of the digastric muscle. Exposure of the cervical vascular sheath with jugular vein, carotid artery and vagus nerve. Sparing of the structures. Exposure of the accessorius nerve and protection of the same. Now successive dissection of the lateral neck preparation while carefully protecting the plexus branches. Subsequent dissection of the remaining soft tissue below the plexus from level V. Careful hemostasis with bipolar coagulation. Several large nodes are seen in level II, these are excised in toto, the accessorius nerve can be spared here. Resection of the medial neck preparation while sparing the hypoglossal nerve. Now turn to the left neck dissection. Here too, infiltration anesthesia with Ultracaine with the addition of adrenaline after skin disinfection. Skin incision on the anterior border of the sternocleidomastoid muscle. Exposure and dissection of the anterior border of the sternocleidomastoid muscle. Exposure of the omohyoid muscle and the digastric muscle. Exposure of the accessorius nerve and protection of the same. Dissection of the cervical vascular sheath with jugular vein, carotid artery and vagus nerve. Now successive dissection of the lateral neck preparation while sparing the plexus branches. Careful hemostasis using bipolar coagulation. Now, post-dissection in the area of the medial neck preparation and removal of the remaining soft tissue while carefully protecting the structures mentioned. Now irrigation on both sides using hydrogen and Ringer's solution. Insertion of a Redon drain. Subcutaneous suture, skin suture. Now insert the mouth retractor again and turn to the primary tumor region. Post-resection in the area of the right uvular margin and the palatal arch. The specimen is sent for final histology. Removal of a marginal sample, which is again sent for frozen section diagnostics. Once again careful hemostasis using bipolar coagulation. In the frozen section, moderate dysplasia is still seen in the marginal sample, no evidence of carcinoma or carcinoma in situ. The operation was therefore terminated after further careful hemostasis. Conclusion: Enormal resection and neck dissection on both sides of a cT2 tongue margin carcinoma on the right. In the frozen section, in addition to the carcinoma, a carcinoma in situ in the area of the palatal arch, therefore, due to the clinical suspicion of field cancerization, adjuvant radiotherapy is indicated. Please present postoperatively at the interdisciplinary tumor conference.