A 40 year old man with a 25 year history of smoking presents with progressive hoarseness of voice, difficulty swallowing and episodes of hemoptysis. He mentioned that he used to be a regular cannabis user. What is the single most likely diagnosis?

The key is D. Squamous cell laryngeal cancer.

• Chronic hoarseness is the most common early symptom.

• Other symptoms of laryngeal cancer include pain, dysphagia, a lump in the neck, sore throat,

earache or a persistent cough.

• Patients may also describe breathlessness, aspiration, haemoptysis, fatigue and weakness, or

weight loss. (Patient.co.uk)