Recurrent syncope in systemic lupus erythematosus: a hidden cause in abdomen

Systemic inflammatory rheumatic diseases have shown an increase in frequency of internal malignancies, predominantly lymphoproliferative disorders. Occurrence of solid organ tumours is exceedingly rare. It is even rarer for it to manifest as recurrent syncope. We report a 55-year-old woman with systemic lupus erythematosus, who later developed episodes of syncope and dizziness along with diaphoresis and palpitations. She also had associated abdominal pain and vomiting. Imaging revealed a gall bladder (GB) mass with hepatic extension, which was histologically consistent with adenocarcinoma of the GB. Subsequently she succumbed to death during chemotherapy.