title: Recurrent syncope as presenting symptom of Burkitt's lymphoma at the carotid bifurcation.
abstract: Burkitt's lymphoma is rare outside of Africa, and head and neck manifestations of this disease are even more uncommon. We report a case of Burkitt's lymphoma localized at the bifurcation of the right common carotid artery in a 64-year-old man. The presenting symptoms were recurrent syncopes that necessitated a pacemaker, followed by a rapid onset of cranial nerve palsies. The tumor had infiltrated cranial nerves IX, X, XI, and XII and was resected by selective neck dissection. The patient was subsequently treated with a chemotherapeutic regimen consisting of a combination of cytosine arabinoside, vincristine, ifosfamide, prednisone, and an intrathecal application of methotrexate. He also underwent external-beam irradiation of the neck. The patient has been followed up for a period of 42 months and has no evidence of recurrent disease. Repeated diagnostic testing and a coordination of multiple disciplines can speed diagnosis and therapeutic management. The current literature is reviewed and discussed.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Freiburg, Germany.
authors.forename: Iakovos
authors.initials: I
authors.lastname: Arapakis
authors.forename: Milo
authors.initials: M
authors.lastname: Fradis
authors.forename: Gerd Jürgen
authors.initials: GJ
authors.lastname: Ridder
authors.forename: Jörg
authors.initials: J
authors.lastname: Schipper
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000150:complications* / Q000628:therapy; D002339:Carotid Arteries; D003389:Cranial Nerve Diseases / Q000209:etiology*; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011882:Radiotherapy, High-Energy; D012008:Recurrence; D013575:Syncope / Q000209:etiology*