Striking A Cord

Question: A 34 year old African American woman is referred to you for hoarseness.  Laryngoscopy reveals pale enlargement of the supraglottis with normal vocal fold mobility.  She has not been ill recently and has no known medical problems.  Review of an old chest X-ray reveals nodularity within the mediastinum.  What is the most likely diagnosis?

[Answer will be posted with next week's new question]

Answer to last week's question, "Think Outside The (Voice)Box" (June 11, 2018)

Amyotrophic lateral sclerosis.