Hoarseness – not just from yelling too much

This unfortunate case features a 59 y.o. male who presents with 3 months of a hoarse voice. He was subsequently found to have a thyroid mass leading to compression of his left recurrent laryngeal nerve, and invasion into his trachea. He had a tracheostomy soon after presentation because of concern about his airway. Biopsy of the mass showed anaplastic thyroid cancer, and his treatment is pending.

Here is a great article about the workup for hoarseness. One major point from the IM perspective is that if there is no resolution of symptoms in 2 weeks and no other obvious treatable cause, direct or indirect laryngoscopy is indicated.

Hoarseness in Adults – Am Fam Physician. 2009 Aug 15;80(4):363-70.