A 45-year-old woman was referred to a tertiary care center for hoarseness. She had a left vocal fold polyp that was removed 2 months earlier at an outside institution, with benign pathology reported. Subsequent stroboscopy revealed a hemorrhagic-appearing polyp (2-3 mm). She was sent for preoperative voice therapy, with plans for excision. However, her voice worsened with therapy, and she returned to the otolaryngology clinic after a few weeks. A larger, 6- to 7-mm, irregular, left vocal fold mass was noted. Preoperative imaging was nonspecific, revealing a small soft-tissue density along the true vocal fold. The patient was taken to the operating room for excision (Figure, A). After the final pathology results were obtained, the patient was taken back to the operating room for cordectomy with negative margins.