Granuloma vs cancer

[Picknewname]

I have had hoarseness of varying degrees since 9/2012, when I was hospitalized with pneumonia. I was subsequently hospitalized in 12/12, 1/13, and 6/13 with pneumonia also. During the 1/13 hospitalization, they finally discovered that I had chlamydia pneumoniae and said it was likely to have been the cause of earlier episodes of pneumonia. I had a horrible, dry, hacking cough that did finally improve about mid-February. My voice improved somewhat, though by the end of the day people could barely understand me. I also have a 15 yr hx of GERD and a 20 yr pack hx. I stopped smoking 8/2001.

The hoarseness worsened around June/July, and then significantly worsened in mid-September. Some days it's better, some worse, but always hoarse and always worse after talking for a few hours (I am in a profession which requires a great deal of speaking). I am constantly clearing my throat and often have a tickling in my throat which leads to coughing. For the last month, I have had an occasional mild burning sensation on the left side of my throat/left ear. Over the last few days it has become almost constant.

I was finally able to see an ENT a couple weeks ago. He did a flexible nasal laryngoscopy and found a lesion on my left vocal cord. He said that just by looking at it, he feels there is a greater than 50% chance of cancer. I am awaiting CT results and will likely have a biopsy within two weeks.

I was rather shocked when he said greater than 50% chance of cancer just by looking. With my history (and the fact that the primary I had been seeing told me the hoarseness was due to the C. Pneumoniae, cough, and then allergies!), I was thinking more along the lines of a granuloma. Granted, the lesion is on the anterior portion of the cord, not, from what I've researched, the typical posterior portion.

I will have an appointment with the ENT to review the CT results and further plans later this week. I am wondering if anyone can suggest further reading/research I can do, questions I need to ask the doctor, and any other information that may help me.

Thank you in advance for your help.

[Picknewname]

Thank you for your reply Dr. Santos. The CT showed the mass on my larynx as well as one "borderline" node in my neck that was not enlarged enough to be considered pathological. The doctor stated that if the CT had been done for a different reason, i.e. headaches, that the node would have been mentioned as an incidental finding but given no significance. However, due to the context of also having a laryngeal mass, it was noted as borderline.

I am having a biopsy of the laryngeal mass tomorrow and will get results next Tuesday. I am praying that it is not cancer.

[Dr Santos]

Hi,
I understand your concern regarding the findings of your ENT. . Hoarseness could indeed be due to to a variety of issues including irritation, infection and trauma to the larynx. While there is risk for malignancy, definite diagnosis  is still with biopsy.  Seeking another specialist's opinion or evaluation may also help. Do keep us posted with the CT scan results. Take care and regards.