[Fainting caused by a neck tumor].
An 86-year-old woman was admitted with progressive complaints of dizziness and the sensation of losing consciousness several times a day; this had led her to fall down on a few occasions. The patient had experienced these symptoms for a month prior to admission. Two weeks before admission her family had noticed a swelling on the left side of her neck. During admission, bradycardia and subsequently asystole occurred while she was eating or when turning her head to the left, followed by a slow junctional escape rhythm. A CT scan of the head and neck region revealed a large tumour in the left parapharyngeal space entrapping the left carotid artery. Histology disclosed a low-grade malignant non-Hodgkin lymphoma, sensitive to radiotherapy. The patient received a pacemaker and treatment of the lymphoma was uneventful. The symptomatic sinus bradycardia and asystole were caused by intermittent carotid massage by the lymphoma.
Winter
J B
JB
Universitair Medisch Centrum Utrecht, Hart-Long Centrum, afd. Cardiologie, Postbus 85.000, 3508 GA Utrecht. j.b.winter@hli.azu.nl
Gevers
R M M
RM
Huitema
A
A
D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013575:Syncope / Q000209:etiology*; D014057:Tomography, X-Ray Computed