A woman in her 90s with no significant medical history presented to the otolaryngology clinic with a chief concern of worsening hoarseness over several years. She had not experienced shortness of breath, gastric reflux, smoking, cough, dysphagia, odynophagia, fevers, or chills. Findings from a physical examination were remarkable for a rough voice. Flexible nasolaryngoscopy revealed normal abduction and adduction of the vocal folds with a white sessile lesion starting at the right midfold on the superior and medial surfaces that crossed the midline to involve the entire left vocal fold as shown in the Figure, A. Histopathologic images of the biopsied lesion are shown in the Figure, B-D.
Vinh D, Haley SL, Ongkasuwan J. A Laryngeal Lesion. JAMA Otolaryngol Head Neck Surg. 2016;142(4):399-400. doi:10.1001/jamaoto.2015.3782