Fig. 19

Lung cancer. A 79-year-old woman with 55-pack-year smoking history presenting with hoarse voice and chronic vomiting. Coronal contrast-enhanced images of the larynx (a) and lungs/mediastinum (b) reveal medialization of the left vocal fold (white arrow) with dilation of the ipsilateral piriform sinus (white arrowhead). A large mass centered in the left upper lobe extends into the aortopulmonary window and also encases a vessel (black arrow). These findings are consistent with left vocal cord paralysis due to compression of the left recurrent laryngeal nerve in the setting of stage IV lung cancer