After induction of anesthesia by the anesthesia colleagues, a rigid tracheoscopy is performed. To do this, enter with 0° optics under laryngoscopic control. The subglottic region and the trachea are revealed. Subsequently intubation by the anesthesia colleagues. Subsequent entry with the small bore tube under dental protection after inspection of the inconspicuous oral vestibule. First inspection of the oropharynx. This is symmetrical and clear. The base of the tongue itself is clear on both sides, as are the lateral walls of the pharynx and the vallecula. Inspection of the hypopharynx, which is clear up to the tips of the piriform sinus and the entrance to the esophagus, and the endolarynx is also inconspicuous. Then perform the flexible esophagogastroscopy. To do this, enter with the gastroscope under laryngoscopic control. Easy to see through to the stomach. This is inconspicuous and clear. The oesophagus is also inconspicuous on reflection. Subsequent exploration of the oral cavity. There is an exophytic, exulcerated mass on the right edge of the tongue, extending from the anterior third to the posterior third. The exulcerated part measures approx. 2 x 1 cm, but with extensive submucosal growth. In this case, the total extension is at least 4 cm in length and at least 1.5 cm deep infiltration. The tumor is cut around with an electric knife with a safety margin of 2 cm. An extensive soft tissue mantle is also left on all sides of the tumor in the area of the musculature. Ligation of stronger vessels from the lingual artery and stronger veins, otherwise hemostasis by coagulation and removal of the tumor macroscopically clearly in sano. The specimen is completely suture-marked for urgent definitive histology. Wound irrigation and, with absolutely dry wound conditions, completion of the procedure without any indication of complications. Conclusion: Intraoperatively, macroscopically extensively resected, submucosally very aggressively growing tongue margin carcinoma. A neck dissection on both sides with defect reconstruction, most likely using an anterolateral thigh graft, should be planned as soon as possible. In the meantime, presentation at our interdisciplinary tumor conference for connection. Postoperatively, initially cautious diet and adequate pain therapy for the extensive wound area.