Fang Chongkai, Yang Liting, Zeng Guangbi, Huang Ruilin, Fang Wei, Chen Yao, Guan Jieshan, Li Peng, Huang Xuewu, Lin Lizhu
First Clinical Medical College, Guangzhou University of Chinese Medicine.
Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University.
Medicine (Baltimore). 2019 Aug;98(35):e16998. doi: 10.1097/MD.0000000000016998.
Syncope caused by head and neck cancer (HNC) is rare. However, syncope caused by tongue cancer (TC) is even rarer. In TC, syncope is caused by tumor-mediated compression of the carotid sinus and stimulation of the glossopharyngeal nerve.
In this study, we report the case of a 48-year-old male patient who was diagnosed with advanced TC and bilateral cervical lymph node metastasis. On the third day of admission, the patient experienced recurrent syncope with hypotension and bradycardia.
The patient was diagnosed with a well-differentiated squamous cell carcinoma of the tongue along with massive cervical lymph node metastasis and carotid sinus syndrome.
Initially, symptomatic treatment of syncope boosted the blood pressure and increased the heart rate. Thereafter, a temporary pacemaker was implanted. Finally, chemotherapy was used to control the tumor and relieve syncope.
After chemotherapy, the tongue ulcers and cervical lymph node reduced in size; syncope did not recur.
This case shows that chemotherapy may be a valid treatment option in patients with cancer-related syncope; however, the choice of chemotherapeutic drugs is critical. Intensive care provides life support to patients and creates opportunities for further treatment.
头颈癌（HNC）引起的晕厥很少见。然而，舌癌（TC）引起的晕厥更为罕见。在舌癌中，晕厥是由肿瘤介导的颈动脉窦压迫和舌咽神经刺激引起的。
在本研究中，我们报告了一例48岁男性患者，他被诊断为晚期舌癌并伴有双侧颈部淋巴结转移。入院第三天，患者出现反复晕厥，伴有低血压和心动过缓。
患者被诊断为高分化舌鳞状细胞癌，伴有大量颈部淋巴结转移和颈动脉窦综合征。
最初，对晕厥进行对症治疗以升高血压和提高心率。此后，植入了临时起搏器。最后，使用化疗来控制肿瘤并缓解晕厥。
化疗后，舌溃疡和颈部淋巴结缩小；晕厥未复发。
该病例表明，化疗可能是癌症相关性晕厥患者的有效治疗选择；然而，化疗药物的选择至关重要。重症监护为患者提供生命支持，并为进一步治疗创造机会。
