|Endocrine System: 56 y/o man with hoarseness|
A 56 year old man presents with a 6 month history of hoarseness. The patient noticed progressive hoarseness over the past year, but particularly worse in the past 6 months. He also noticed firmness in his throat and discomfort when swallowing. His past medical history is unremarkable, except for enlarged tonsils as a child for which he received radiation therapy. Physical examination reveals a hoarse sounding voice and a thyroid gland which was immobile and felt hard on palpation. Cervical lymph nodes were also palpable.