This 47-year-old male with a history of liver cirrhosis and HBV was admitted to the ER for hemoptysis for 2 days. He has a left neck mass and complaints of dysphagia and bleeding after eating. A CT scan showed a bulky tumor involving the left lateral oropharyngeal, hypopharyngeal and laryngeal walls, with enlarged lymph nodes. A laryngoscopy found a left hypopharyngeal cancer with ulceration and blood clot but no active bleeding. The tentative diagnosis is left hypopharyngeal cancer with ulceration and active bleeding status post endotracheal intubation to protect the airway, along with anemia from tumor bleeding,