A case of pseudoaneurysm bleeding at salvage surgery after chemo-radiation therapy for hypopharyngeal cancer

With advances in drug therapy, the indications for chemo-radiation therapy (CRT) for head and neck carcinoma have expanded, and at the same time, the frequency of salvage surgery at recurrence has increased. Complications after salvage surgery include wound infection, fistula, and wound dehiscence, sometimes leading to fatal complications, such as total flap necrosis and carotid artery rupture, which are generally more frequent than in cases of initial surgery. We herein report a case of massive bleeding from a pseudoaneurysm in a branch of the lingual artery as a postoperative complication of salvage surgery after CRT. Previous reports have suggested a history of irradiation, surgery, and inflammation associated with ulceration as potential causes of pseudoaneurysm formation, which should be kept in mind as a possible postoperative complication in patients with such histories. (author)