Key result
Cervical radiotherapy shrinks metastatic tumor and resolves recurrent syncope for ~1 year.
Why the study?
Cardiological and neurological evaluations failed to identify a clear cause of recurrent syncopal episodes in a 74-year-old patient.
Case Report (n=1)
No
This case report highlights that metastatic cervical tumors compressing the carotid sinus can trigger recurrent neurocardiogenic syncope via baroreceptor dysregulation, which can be effectively resolved by reducing tumor mass through radiotherapy.
Answers are grounded in this paper and cite their sources.
May support radiotherapy consideration in tumor-compressed carotid sinus syncope; leaves open need for prospective validation before practice change.
A 74-year-old patient was evaluated and treated for recurrent syncopal episodes. Appropriate diagnostic investigations were performed; however, cardiological and neurological evaluations failed to identify a clear cause of syncope. Autonomic nervous system testing revealed autonomic dysfunction. Further diagnostic workup identified metastatic squamous cell carcinoma in the lateral cervical region, with enlarged lymph nodes, extranodal invasion of the soft tissues, and infiltration of neural and vascular structures. Compression of the carotid sinus by the tumor mass was considered the presumed trigger of the syncopal episodes. Afferent impulses from the carotid sinus baroreceptors are transmitted via Hering's nerve and the glossopharyngeal nerve to the brainstem, where they induce a reduction in heart rate and vascular tone. Following radiotherapy and reduction of the tumor mass, the syncopal episodes resolved, supporting the proposed mechanism underlying the patient's symptoms.
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Kutlešić-Kurtović et al. (2026) conducted a case report in Recurrent syncope caused by metastatic squamous cell carcinoma compressing the carotid sinus nerve plexus (n=1). Cervical radiotherapy and discontinuation of beta-blocker (bisoprolol) was evaluated on Resolution of syncopal episodes and reduction in cervical tumor mass. Radiotherapy (60 Gy in 30 fractions) reduced the cervical metastatic tumor mass from 46x32x54 mm to 23x11 mm and resolved recurrent syncopal episodes for one year until cancer progression.
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