What is a likely cause of this gentleman's left vocal cord palsy?
Local mass effect may be contributing but the left recurrent laryngeal nerve innervates the larynx and its path descends into the thorax and may be compressed by any hilar or mediastinal masses.
Bulky left hilum with left mid- and lower-airspace opacification.
Fullness in the superior mediastinum with significant tracheal deviation to the right.