The patient is an elderly male, 83 years old, with an optimistic personality and positive attitude towards treatment. He has limited lateral hypopharyngeal carcinoma, but the extent of lymph node metastasis in the neck is surprising. At the time of admission, the left side of the neck was completely rigid, and the lymph nodes fused into an egg-sized hard mass with unclear borders and complete fixation, as you can see from his pet images. The lymph node dissection in the neck took 3 and a half hours to completely remove the diseased lymph nodes, and a partial hypopharyngectomy with a lateral pharyngeal approach was performed at the same time. The importance of complete surgical resection can be seen, even in advanced stage patients can gain hope for survival and good quality of life, respect life and don’t give up lightly!