Young 16 year old boy presented with neck swelling for 6 months associated with cough , hoarseness of voice. On examination swelling is irregular and enlarges in size on cough. Kindly comment.

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Get a CECT done as it looks like a case of thoracic inlet tumour or pancoast tumour. A CECT guided F NAC or a transbronchial biopsy is advisable for further evaluation

Probably a laryngocele as per history detailed here

Laryngocele

AV malformation

Thoracic inlet tumour , dumbbell shaped , need trapdoor incision like hockey sticke above and sternothoracotomy in 5 the space , explain the risk of rln palsy may require tracheostomy later and chance of thoracic duct injury r high so may have chylothorax in post op

Sorry laryngocele

Laryngocoel

Post mediastinal mass

Thyroid mass. Adv....CT scan

Go for CT neck .... fnac... sos excision biopsy

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