Male, 64 years old.

Current smoker 10-15 cig/day (30P/Y). Former enol 6 UBE day until 2016.

History: Obstructive sleep apnea (CPAP), Kidney transplant in 2019 + immunosuppressive treatment, Cirrhosis Child A, Moderate COPD. Hypertensive heart disease and a history of TIA.

First symptom: dysphonia of 2 months of evolution.

FN: neoformation occupying the entire length of the most irregular CVD 2/3 posterior and leukoplastic lesion crossing AC. NBI without pathological pattern due to hyperkeratosis. Preserved laryngeal mobility.

Biopsy (office): severe dysplastic/c.in situ lesion. This is a small biopsy and does not conclusively allow the assessment of infiltration

CT: Neo proliferation in the right vocal cord without involvement of cartilage or anterior commissure. No enlarged lymph nodes.

Tumor board: ca. in situ vs T1a-T1bN0M0 of the larynx . Proposed for TLM