A man in his 90s was admitted for a 2-month history of progressive hoarseness. He had a medical history of an aortic arch pseudoaneurysm with dimensions of 5.0 × 4.0 × 4.2 cm, which had been discovered incidentally by aortic computed tomographic angiography 9 years earlier (Figure, A), at which point he was asymptomatic and refused surgical repair. What was the pseudoaneurysm like on this admission, and what was the diagnosis for his hoarseness?