Mixed-Type Carotid Sinus Syndrome in a Patient With Advanced Laryngeal Cancer: A Case Report

Head and neck tumors can rarely cause carotid sinus syndrome (CSS), a condition characterized by bradycardia, hypotension, and syncope. A 68-year-old male with advanced laryngeal cancer presented with syncope. Examination revealed a fixed 5 cm submandibular mass. Computed tomography angiography (CTA) neck showed a large mass encasing the carotid arteries. During the hospital stay, the patient experienced recurrent bradycardia and hypotension, which were resolved when his neck was turned to the left. Diagnosis of mixed-subtype CSS secondary to tumor compression was assumed. Blood tests, EKG, and CT imaging ruled out other causes. The tumor's encasement of the carotid arteries likely triggered the carotid sinus reflex during head movement. Both cardioinhibitory and vasodepressor components were present, suggesting a mixed subtype of CSS. CSS should be considered in patients with head and neck cancer, presenting with unexplained bradycardia or hypotension. Multidisciplinary management is the key to accurate diagnosis and treatment.