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A false aneurysm

Published online by Cambridge University Press:  30 March 2012

D Mitchell ,
C Repanos  and
W B Coman
D Mitchell
Affiliation:
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
C Repanos*
Affiliation:
Department Head and Neck Surgery, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
W B Coman
Affiliation:
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
*
Address for correspondence: Mr Costa Repanos, ENT Department, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Ports mouth, UK, P06 3LY E-mail: costa@repanos.com
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Abstract

Objective:

We report a case of a remaining hemi-thyroid following laryngectomy, which was misinterpreted as a pseudoaneurysm.

Methods:

Case report and comment on this understandable error which is easily avoidable.

Results:

A 59-year-old man had undergone salvage laryngectomy for recurrent squamous cell carcinoma of the larynx, which had previously been treated with radiotherapy. Three months after his laryngectomy, he presented with a sore neck and subcutaneous collections. Computed tomography revealed a unilateral mass with high signal contrast uptake anterior to the left common carotid artery, which was thought initially to be a carotid pseudoaneurysm. Further investigation, including ultrasonography and a review by the senior head and neck radiologist, demonstrated that this mass was actually the remnant hemi-thyroid preserved at laryngectomy (which is often misshapen compared with a normal hemi-thyroid). The collections were found to be recurrent tumour, and unnecessary further interventions were avoided.

Conclusion:

Ultrasonography easily distinguishes between a thyroid remnant and a pseudoaneurysm. Furthermore, the opinion of an experienced head and neck radiologist may be vital when interpreting complex post-surgical head and neck radiology.

Keywords

PseudoaneurysmSquamous Cell CarcinomaFalse AneurysmUltrasound
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 126 , Supplement S2 , July 2012 , pp. S14 - S15
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Cummings, CW. Otolaryngology Head & Neck Surgery 2005;16:3692–3Google Scholar
2Nadig, S, Barnwell, S, Wax, MK. Pseudoaneurysm of external carotid artery – review of literature. Head Neck 2009;31:136–9CrossRefGoogle ScholarPubMed
3Iguchi, H, Takayama, M, Kusuki, M, Nakamura, A, Kanazawa, A, Hachiya, K et al. Carotid artery pseudoaneurysm as a sequela of surgery for laryngeal cancer. Acta Otolaryngol 2006;126:557–60CrossRefGoogle ScholarPubMed
4Girishkumar, T, Sivakumar, M, Andaz, S, Santosh, V, Solomon, R, Brown, M. Pseudo-aneurysm of the carotid bifurcation secondary to radiation. J Cardiovasc Surg (Torino) 1999;40:877–8Google ScholarPubMed
5Flor, N, Sardanelli, F, Ghilardi, G, Tentori, A, Franceschelli, G, Felisati, G et al. Common carotid pseudoaneurysm after neck dissection: colour Doppler ultrasound and multidetector computed tomography findings. J Laryngol Otol 2007;121:497–500CrossRefGoogle ScholarPubMed
6Cheng, KY, Lee, KW, Chiang, FY, Ho, KY, Kuo, WR. Rupture of radiation induced internal carotid artery pseudoaneurysm in a patient with nasopharyngeal carcinoma – spontaneous occlusion of carotid artery due to long term embolizing performance. Head Neck 2008;30:1132–5CrossRefGoogle Scholar
7Chen, HC, Lin, CJ, Jen, YM, Juan, CJ, Hsueh, CJ, Lee, JC et al. Ruptured internal carotid pseudoaneurysm in a nasopharyngeal carcinoma patient with skull base osteoradionecrosis. Otolaryngol Head Neck Surg 2004;130:388–90Google Scholar
8Maruyama, Y, Arai, K, Hoshida, S, Yoneda, K, Furukawa, M, Yoshizaki, T. Case of three delayed complications of radiotherapy: bilateral vocal cord immobility, esophageal obstruction and ruptured pseudoaneurysm of carotid artery. Auris Nasus Larynx 2009;36:505–8CrossRefGoogle ScholarPubMed
9Tanaka, S, Kimura, Y, Furukawa, M. Pseudoaneurysm of the carotid artery with haemorrhage into the hypopharynx. J Laryngol Otol 1995;109:889–91Google Scholar
10Minion, DJ, Lynch, TG, Baxter, BT, Lieberman, R. Pseudoaneurysm of the external carotid artery following radical neck dissection and irradiation: a case report and review of literature. Cardiovasc Surg 1994;2:607–11Google Scholar