Syncope is caused by a wide variety of disorders. Recurrent
syncope as a complication of
malignancy is uncommon and may be difficult to diagnose and to treat. Primary neck
carcinoma or
metastases spreading in parapharyngeal and carotid spaces can involve the internal carotid artery and cause neurally mediated
syncope with a clinical presentation like carotid sinus syndrome. We report the case of a 76-year-old man who suffered from recurrent
syncope due to invasion of the right carotid sinus by
metastases of a
carcinoma of the esophagus, successfully treated by
radiotherapy. In such cases, surgery,
chemotherapy or
radiotherapy can be performed. Because
syncope may be an early sign of neck or
cervical cancer, the diagnostic approach of
syncope in patients with a past history of
cancer should include the possibility of neck
tumor recurrence or
metastasis and an oncologic workout should be considered.