84-year-old man.

Former smoker (40 pack-years).

Medical history: Hypertension. Underwent surgery for an abdominal aortic aneurysm with femoral artery bypass and left-sided stent placement 2 years ago. Currently on Adiro (aspirin). Left and right inguinal hernia repair.

Presenting complaint: Dysphonia for the past 2 months, unrelated to any viral illness.

Examination: Exophytic lesion involving the middle third of the right vocal cord (RVC), extending to the anterior commissure (AC). The ventricle and subglottis are clear. Vocal cord mobility seems preserved.

Neck CT: Thickening of the surface of the posterior two-thirds of the right vocal cord, with probable posterior extension into the laryngeal ventricle. No adenopathies.

Chest CT: No relevant abnormalities.

Assessment: Patient with suspected laryngeal tumour, staged as T2 based on CDI???

Management MTB: Transoral laser microsurgery (TLM) is proposed. If feasible, complete resection (RC); otherwise, biopsy to assess the possibility of radical treatment with subsequent radiotherapy (RT).