An unusual cause of hoarseness.

A 55-year-old man had a 3 month history of hoarseness and choking when he drinks liquids. Physical examination revealed evidence of left sided palsy of 9th, 10th, 11th and 12th cranial nerves. A brain MRI revealed a skull base lytic lesion. The authors diagnosed Collet-Sicard syndrome. The patient was found to have colon cancer. He received palliative skull radiotherapy and died few weeks later in hospice care.