Background

Advancements in diagnostic modalities have brought many hidden etiological causes of unilateral vocal cord paralysis (UVCP) to light. Here we are presenting two cases of gastrointestinal (GI) malignancies with metastases causing UVCP which can further add to another rare cause of UVCP.

Case summary

We are presenting a case of 40 year  male with metastatic periampullary carcinoma leading to UVCP and another case of 45 year female with rectal carcinoma further causing UVCP. Both patients were under treatment while during follow–up, symptoms of UVCP were observed which changed our perspective towards cases of UVCP.

Conclusion

Vocal cord palsy is a symptom of an underlying disorder and not a disease. In above case reports metastases are the commonest etiology for vocal cord palsy. Relevant investigations have to be conducted in order to diagnose the etiology and the modality of treatment varies depending on the etiology of the condition.