Carotid bypass surgery for a persistent neck tumor after multiple treatments: a case report

  • Izry Naomi Lumbantobing Department of Otorhinolaryngology, Royal Prima Hospital, Medan, Indonesia
  • Mohd Razif Mohamad Yunus Department of Otorhinolaryngology, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia
  • Arman Zaharil Mat Saad Department of Plastic and Reconstructive Surgery, Management & Science University Medical Centre, Selangor, Malaysia https://orcid.org/0000-0002-4003-6783
Keywords: carotid artery, neck node metastasis, reconstructive surgical procedures, squamous cell carcinoma, vascular surgical procedures
Abstract viewed: 407 times
PDF downloaded: 330 times
HTML downloaded: 61 times
EPUB downloaded: 72 times

Abstract

Carotid artery involvement in head and neck cancer is challenging for surgeons and oncologists, particularly in recurrence or residual disease following multiple treatments. However, carotid artery resection and reconstruction can be safely performed in a carefully selected patient with local and regional control benefits despite the potential morbidity and high-risk complications. We presented a case of primary laryngeal cancer treated with chemoradiotherapy, modified radical neck dissection type I for residual neck node disease, and further chemotherapy. Although the primary laryngeal cancer showed a complete response, the residual neck tumor was still unresolved and even involved the carotid artery. Therefore, carotid resection with a combined saphenous vein graft and free flap reconstruction was the treatment of choice for this patient. It is effective and safe, and the risk of morbidity has been accepted.

Downloads

Download data is not yet available.

References

  1. Manzoor NF, Russell JO, Bricker A, Koyfman S, Scharpf J, Burkey B, et al. Impact of surgical resection on survival in patients with advanced head and neck cancer involving the carotid artery. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1219-25. https://doi.org/10.1001/jamaoto.2013.4917

  2. Mourad M, Saman M, Stroman D, Lee T, Ducic Y. Carotid artery sacrifice and reconstruction in the setting of advanced head and neck cancer. Otolaryngol Head Neck Surg. 2015;153(2):225-30. https://doi.org/10.1177/0194599815586719

  3. Kim Y, Philouze P, Malard O, Dufour X, Nokovitch L, Céruse P, et al. Resection and reconstruction of the carotid artery for head and neck squamous cell carcinoma: a GETTEC study. Eur Arch Otorhinolaryngol. 2022;279(9):4515-23. https://doi.org/10.1007/s00405-022-07342-6

  4. Maruthamuthu T, Sanjeevan N, Aziz ME, Mat Saad AZ, Abdullah B. Carotid artery resection and reconstruction for recurrent laryngeal carcinoma with carotid artery involvement: case report. Med Flum. 2018;54(1):64-7. https://doi.org/10.21860/medflum2018_192876

  5. Agarwal J, Kundu S, Krishnatry R, Gupta T, Murthy V, Budrukkar A, et al. Salvage neck dissection after chemoradiation in head and neck cancer: practice and pitfalls. Int J Head Neck Surg. 2012;3(1):15-21. https://doi.org/10.5005/jp-journals-10001-1083

  6. Lodder WL, Lange CA, Teertstra HJ, Pameijer FA, van den Brekel MW, Balm AJ. Value of MR and CT imaging for assessment of internal carotid artery encasement in head and neck squamous cell carcinoma. Int J Surg Oncol. 2013;2013:968758. https://doi.org/10.1155/2013/968758

  7. Raheja A, Couldwell WT. Cavernous sinus meningioma. Handb Clin Neurol. 2020;170:69-85. https://doi.org/10.1016/B978-0-12-822198-3.00029-X

  8. Kalani MY, Kalb S, Martirosyan NL, Lettieri SC, Spetzler RF, Porter RW, et al. Cerebral revascularization and carotid artery resection at the skull base for treatment of advanced head and neck malignancies. J Neurosurg. 2013;118(3):637-42. https://doi.org/10.3171/2012.9.JNS12332

  9. Yang R, Wu H, Chen B, Sun W, Hu X, Wang T, et al. Balloon test occlusion of internal carotid artery in recurrent nasopharyngeal carcinoma before endoscopic nasopharyngectomy: a single center experience. Front. Oncol. 2021;11:674889. https://doi.org/10.3389/fonc.2021.674889

  10. Matsubara N, Izumi T, Okamoto S, Araki Y, Shintai K, Tajima H, et al. Multimodal assessment for balloon test occlusion of the internal carotid artery. J Neuroendovascular Ther. 2016;10(3):108-15. https://doi.org/10.5797/jnet.oa.2015-0012

  11. Illuminati G, Schneider F, Minni A, Calio FG, Pizzardi G, Ricco JB. Resection of recurrent neck cancer with carotid artery replacement. J Vasc Surg. 2016;63(5):1272-8. https://doi.org/10.1016/j.jvs.2015.10.098

  12. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, et al, editors. AJCC cancer staging manual. 6th ed. New York: Springer; 2002. https://doi.org/10.1007/978-1-4757-3656-4

  13. Majumdar KS, Rao VUS, Prasad R, Ramaswamy V, Sinha P, Subash A. Incidence of micrometastasis and isolated tumour cells in clinicopathologically node-negative head and neck squamous cell carcinoma. J Maxillofac Oral Surg. 2020;19(1):131-5. https://doi.org/10.1007/s12663-019-01239-4

Published
2022-09-22
How to Cite
1.
Lumbantobing IN, Mohamad Yunus MR, Mat Saad AZ. Carotid bypass surgery for a persistent neck tumor after multiple treatments: a case report. Med J Indones [Internet]. 2022Sep.22 [cited 2024Jul.3];31(3):202-6. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/6130
Section
Case Report/Series