Collet Siccard Syndrome without skull base metastasis : A rare presentation of bronchogenic adenocarcinoma

Abstract

A 54 year old female on evaluation of dysarthria was found to have left IX, X and XII cranial nerve palsy. General physical examination revealed bilateral cervical level V multiple lymph nodes which were firm to hard and nontender; respiratory system examination suggested left sided mild pleural effusion. MRI brain and cervical spine did not show any evidence of meningeal enhancement or skull base metastasis. Bronchoscopy revealed a mass lesion in left main bronchus. Her cranial nerve symptoms were attributed to Collet-Sicard syndrome because of the lymph node metastasis from lung cancer. It is a rare case of Collet-Sicard syndrome resulting from lymph node metastasis of adenocarcinoma of lung and is important as a differential diagnosis of lower cranial nerve palsy.