Head and neck surgeon Carole Fakhry, director of the Johns Hopkins Head and Neck Cancer Center, describes the case of a patient who presented to the Johns Hopkins Head and Neck Cancer Multidisciplinary Clinic team with a right-sided neck mass that had been diagnosed by fine needle aspiration as HPV-associated squamous cell carcinoma. It was determined he had a base of tongue mass. After discussion with the Johns Hopkins team and his family, the patient opted to move forward with a transoral resection of the 5-centimeter base of tongue tumor and neck dissection. Although the tumor was removed completely, the patient received chemoradiation therapy post-surgery as pathology found 5 millimeters of extra nodal extension.