We report a right-sided tonsillar carcinoma in a 33-year-old renal graft recipient on cyclosporine A plus low dose prednisolone treatment. The patient had been a life-long non-smoker and alcohol abstainer. The undifferentiated rapidly growing tumour became manifest in the fifth year after transplantation. The clue to the early recognition of this aggressive tumour (T2N0M0G3) resulting in a hitherto favourable outcome after excision and irradiation above all lied in the alertness of the patient himself.