Successful Treatment of Syncope with Chemotherapy Irresponsive to Cardiac Pacemaker in Head and Neck Cancer

다국어 초록 (Multilingual Abstract)

Recurrent syncope as a complication of recurrent neck malignancy is an uncommon but well documented
association. The syncope is presumed to occur when a tumor mass invades the baroreceptor within the carotid sinus
or when it disrupts the afferent nerve fibers of the glossopharyngeal nerve. A 59-year-old man presented with
recurrent syncope and headache. He had a wide local excision including tonsillectomy and modified left radical
neck dissection for tonsilar cancer 4 years ago. A computed tomography scan revealed ill-defined lesions in left
parapharyngeal, carotid space and right upper jugular region. After clinical evaluation, cardiac pacemaker was
placed, but he still suffered from the syncope. Then, he received the chemotherapy with docetaxel and cisplatin.
The last hypotension event occurred on day 10 of the chemotherapy. Six months after 3 cycles of chemotherapy, he
remained in complete remission and resolution of syncope. We report a case in which syncope was associated with
a recurrence of tonsilar cancer and successfully treated with chemotherapy.

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