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Syncope caused by lymphomatous encasement of the internal carotid artery
  1. Ellery Altshuler1,
  2. Mahmoud Aryan1,
  3. Jess Delaune2 and
  4. James Lynch2
  1. 1 Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  2. 2 Hematology and Oncology, College of Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Ellery Altshuler; ElleryAltshuler{at}


We present a case of a 77-year-old man who reported 5 months of syncopal episodes. He was found to have diffuse large B-cell lymphoma encasing the left internal carotid artery but not impeding blood flow. The syncopal episodes resolved after his first cycle of chemotherapy. Recurrent syncope in non-cardiac lymphomas and other head and neck masses is exceedingly rare and may be due to reflex syncope prompted by carotid baroreceptor activation. There are 11 previously described cases of recurrent syncope associated with non-cardiac lymphoma. In all cases, lymphadenopathy abutting the carotid artery was present and the syncopal episodes resolved with treatment. Our case illustrates that malignancy should be considered in patients with unexplained recurrent syncope.

  • oncology
  • head and neck cancer
  • chemotherapy

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  • Contributors EA conceived of the idea for the project, did much of the background research, and is responsible for the final manuscript. MA helped write the manuscript and assisted with background research. JD assisted with writing the manuscript. JL helped oversee the project and helped write the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.