Park JS, Jang HG. Endovascular treatment of a ruptured pseudoaneurysm of the internal carotid artery in a patient with nasopharyngeal cancer: A case report. World J Clin Cases 2022; 10(25): 9121-9126 [PMID: 36157641 DOI: 10.12998/wjcc.v10.i25.9121]
Corresponding Author of This Article
Hyoung Gyu Jang, MD, Attending Doctor, Department of Neurosurgery, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54709, South Korea. 23175@jbuh.co.kr
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2022; 10(25): 9121-9126 Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.9121
Endovascular treatment of a ruptured pseudoaneurysm of the internal carotid artery in a patient with nasopharyngeal cancer: A case report
Jung-Soo Park, Hyoung Gyu Jang
Jung-Soo Park, Hyoung Gyu Jang, Department of Neurosurgery, Jeonbuk National University Medical School and Hospital, Jeonju 54907, South Korea
Author contributions: Park JS wrote the manuscript; Park JS and Jang HG collected the data and participated in patient care; Jang HG reviewed and edited the manuscript.
Supported byFund of Biomedical Research Institute, Jeonbuk National University Hospital.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyoung Gyu Jang, MD, Attending Doctor, Department of Neurosurgery, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54709, South Korea. 23175@jbuh.co.kr
Received: April 13, 2022 Peer-review started: April 13, 2022 First decision: May 31, 2022 Revised: June 13, 2022 Accepted: July 25, 2022 Article in press: July 25, 2022 Published online: September 6, 2022 Processing time: 134 Days and 1.8 Hours
Abstract
BACKGROUND
Radiation therapy (RT) for nasopharyngeal cancer can cause several complications. In rare cases, an internal carotid artery pseudoaneurysm can occur, which can be fatal. We report the experience of a nasopharyngeal cancer patient who underwent radiation therapy and subsequently developed a fatal pseudoaneurysm of the petrous internal carotid artery.
CASE SUMMARY
A 39-year-old man was diagnosed with nasopharyngeal cancer 2 years ago (American Joint Committee on Cancer Stage T3N2M0) and received concurrent chemoradiation therapy. He subsequently relapsed and received chemotherapy. One week after the 4th cycle of chemotherapy, he was admitted to the emergency room of our hospital because of massive epistaxis accompanied by a headache. A pseudoaneurysm of the petrous internal carotid artery was confirmed by digital subtraction angiography (DSA). Stent-assisted endovascular coil embolization was performed and complete occlusion was achieved. No pseudoaneurysm was observed on DSA after coil embolization; however, intermittent epistaxis was maintained even after coil embolization. After seven days, a diagnostic laryngoscopy was performed. Massive bleeding occurred after aspiration of the blood clot during the laryngoscopy and the patient died of hypovolemic shock. In this case, epistaxis may have been a sign of pseudoaneurysm; therefore, treatment such as embolization should be performed promptly, and careful management should be undertaken after treatment.
CONCLUSION
This case highlights a rare, serious complication of RT in nasopharyngeal cancer and how it should be recognized and treated.
Core Tip: We report a patient who developed pseudoaneurysm in a nasopharyngeal cancer patient. By reporting our mistakes, we hope that our readers will not make the same mistakes as us.
