Presentation
Six months of hoarseness.
Patient Data
Mass-like opacity right lung apex with additional patchy increased opacity and mild volume loss right upper lobe. Left lung clear. Cardiac silhouette normal in size, no pleural effusion.
The right vocal cord is paralyzed. There is a right upper lobe mass with right paratracheal lymphadenopathy with tracheal invasion extending superiorly to the level of the right subclavian artery.
Case Discussion
Remember that thoracic abnormalities such as aneurysms, masses and adenopathy may compress and compromise the recurrent laryngeal nerves. In this case the enlarged mteastatic lymph nodes from the right upper lobe lung cancer compromised the right recurrent laryngeal nerve as it coursed beneath the right subclavian artery causing right vocal cord paralysis.
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