A 67-year-old woman with a history of left true vocal fold paralysis presented with a 6-day history of worsening dysphonia, dyspnea, and noisy breathing. She complained of dysphagia to solids but not to liquids. She did not have any fevers, chills, otalgia, or weight loss. Examination of her larynx revealed a left vocal cord mass with extension into the subglottis and a fixed left vocal fold. Her airway was significantly narrowed. The findings of the rest of the examination were significant only for biphasic stridor and a 2×2-cm mass in the anterior aspect of the neck.