Presentation to A+E with stridor. History of persistent cough (not responding to antibiotics) and 2 stone weight loss over three months. Also dysphonia and dysphagia to solids (one month). Current smoker. Large fixed level IV mass on left. On nasal endoscopy, fixed left cord and blood at piriform fossa. Normal CXR five months previously.

Patient Data

Age: 70 years
Gender: Male