Small-cell lung cancer with recurrent syncope as the initial symptom: A case report and literature review

Jiang,Xi; Zhao,Jiayi; Bai,Chengguang; Xu,Enhong; Chen,Zhenhao; Han,Yiping

doi:10.3892/mco.2016.1032

Small-cell lung cancer with recurrent syncope as the initial symptom: A case report and literature review

Authors:
- Xi Jiang
- Jiayi Zhao
- Chengguang Bai
- Enhong Xu
- Zhenhao Chen
- Yiping Han
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Affiliations: Graduate Management Unit, Changhai Hospital, the Second Military Medical University, Shanghai 200433, P.R. China, Department of Respiratory and Critical Care, Changhai Hospital, the Second Military Medical University, Shanghai 200433, P.R. China, Department of Pathology, Changhai Hospital, the Second Military Medical University, Shanghai 200433, P.R. China
Published online on: September 21, 2016 https://doi.org/10.3892/mco.2016.1032
Pages: 545-549
Copyright: © Jiang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Small-cell lung cancer (SCLC) presenting with syncope as the initial symptom is rare in adults. This onset of tumour-induced syncope cannot be screened or differentiated by coronary angiography, magnetic resonance angiography of the neck or 24-hour dynamic electrocardiogram. We herein describe the case of a 61-year-old man who presented with recurrent syncope that resolved after the first course of chemotherapy (carboplatin plus etoposide) for SCLC. A mass measuring 57x53 mm was identified in the left hilum, and a diagnosis of limited-disease SCLC (T4N2M0, IIIB) was made. Considering the rapid and complete remission after the treatment of the primary lesion, we hypothesised that the syncope was neurogenic and associated with cancer. Thus, 8 similar cases retrieved from PubMed were reviewed and, for the first time, the mechanism underlying the syncope was identified, which may involve tumour location, neurobiology and other inducing factors. Thus, for the treatment of such SCLC patients, standard chemotherapy is crucial for preventing syncopal attacks.

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