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Delayed carotid blow-out syndrome: a new complication of chemoradiotherapy treatment in pharyngolaryngeal carcinoma

Published online by Cambridge University Press:  11 September 2012

E Esteller ,
X León ,
M de Juan  and
M Quer
E Esteller
Affiliation:
Otorhinolaryngology Department, Hospital General de Catalunya, Spain
X León*
Affiliation:
Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau (Universitat Autònoma de Barcelona), Barcelona, Spain
M de Juan
Affiliation:
Department of Radiodiagnosis, Hospital de la Santa Creu i Sant Pau (Universitat Autònoma de Barcelona), Barcelona, Spain
M Quer
Affiliation:
Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau (Universitat Autònoma de Barcelona), Barcelona, Spain
*
Address for correspondence: Dr Xavier León, Otorhinolaryngology Department, Hospital de Sant Pau, Avda San Antoni Ma Claret 167, 08025 Barcelona, Spain Fax: +34 93 556 56 04 E-mail: xleon@santpau.cat
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Abstract

Background:

Carotid blow-out syndrome is one of the most devastating complications of head and neck carcinoma. It usually occurs as a post-operative complication or when the tumour compromises the vascular axis.

Methods and results:

We report two patients who suffered carotid blow-out syndrome but who did not have the usual predisposing factors. Both patients had a pharyngolaryngeal carcinoma that was treated with chemoradiotherapy. Residual non-tumoural ulceration was seen along the lateral wall of the hypopharynx in both cases. This ulceration eventually reached the vascular axis, precipitating carotid rupture and death.

Conclusion:

Residual non-tumoural ulceration of the lateral wall of the hypopharynx after chemoradiotherapy should be considered with the utmost caution. Once persistence of the tumour is excluded, surgery is indicated to protect the vascular axis, in order to prevent carotid blow-out syndrome.

Keywords

Carotid Artery DiseasesLarynxPharynxCarcinomaComplicationChemoradiotherapy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1189 - 1191
Copyright
Copyright © JLO (1984) Limited 2012

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