A 74 year old female patient was presented to our institution after a tracheotomy that was performed in the local hospital, with a history of a dysphagia, dyspnea and 15-kg weight loss during the last six months. She denied tobacco or alcohol use. In the family history her brother had laryngeal cancer. Physical examination revealed a 3 cm mass in the right parotid gland with normal overlying skin.Intraorally there was an 5 cm mass (submucosal lesion) filling the pharynx that appeared to originate from the posterior pharyngeal wall. A neck CT scan revealed a oro- and hypopharyngeal prevertebral mass 20x43x46mm that was extending into the spinal canal and intervertebral foramen causing near complete occlusion of the oro and hypopharynx. CT scan showed also a mass 22x28x22mm in the right parotid gland. CT angiography revealed atherosclerotic plaques and stenosis in the internal carotid arteries. The patient had also had a normal CT scan of paranasal sinuses. Due to the anatomy complexity, complete resection of the tumor through a transoral-transpharyngeal approach was not possible. Intraoperative palpation of the mass revealed well defined submucosal lesion 20x43x46mm beginning at the level of the oro- and hypopharynx and extending superiorly to the nasopharynx, and posteriorly into the spinal canal and intervertebral foramen causing near complete occlusion of the oro and hypopharynx. The patient also underwent extracapsular dissection of the parotid tumor. Postoperative palliative radiotherapy was performed.