失神発作を初発症状とした上咽頭腫瘍の1症例

Epipharyngeal Cancer Associated with Carotid Sinus Hypersensitivity Syndrome: Report of a Case

I．はじめに

　頭頸部の悪性腫瘍で頸部リンパ節転移のコントロールが不良な症例では，頸動脈洞反射が過敏反応を示し時に失神発作を繰り返すことが報告されている。しかしこれらの症例のほとんどは末期癌患者であり，初発症状として失神発作を起こした例はいまだ報告がない。

　一方上咽頭癌は局所の症状が出にくく早期に頸部リンパ節転移を起こしやすい。そのため頸部腫瘤を主訴として受診し初めて上咽頭癌の発見される症例も少なくない。

　A 65-year-old man with epipharyngeal cancer (T₄N₃M₀) who showed syncopal attack as the initial symptom is reported. The syncopal attack was caused by carotid sinus hypersensitivity syndrome owing to the cervical metastasis near the carotid sinus, and the symptoms were disappeared by irradiation.

　Generally, the symptoms of the patients with advanced neck metastasis were various. However, no patient with syncope as the initial symptom has been reported. The patient was completely free from the attack after the radiation therapy.