Endovascular Treatment for Primary Tumor Hemorrhage in Oropharyngeal Carcinoma: A Report of Two Cases

TL;DR

This paper reports two successful cases of using endovascular treatment to stop life-threatening bleeding in patients with oropharyngeal cancer.

Contribution

The study highlights the effectiveness of endovascular treatment for tumor-related bleeding in head and neck cancer patients.

Findings

Endovascular treatment successfully achieved hemostasis in two cases of primary tumor bleeding.

Early treatment allowed for resumption of irradiation and chemotherapy, potentially improving long-term outcomes.

Endovascular treatment is more effective for oropharyngeal tumor bleeding than for carotid artery hemorrhage.

Abstract

Acute arterial hemorrhage is a damaging and sometimes lethal complication that occurs in patients with head and neck cancer. However, achieving hemostasis can be challenging because of the difficulty in applying pressure in the throat and oral cavity. In this context, endovascular treatment (ET) has been performed in recent years. This report aims to describe the benefits of ET for acute bleeding. Additionally, our findings emphasize the importance of early diagnosis and treatment of tumor-related bleeding, not only for immediate life-saving benefits but also for the potential resumption of irradiation and chemotherapy, which can lead to favorable long-term prognoses in some instances. We describe two cases of primary tumor bleeding where treatment was successful with ET. Neurosurgeons performed these treatments, and effective hemostasis was achieved in both cases. No complications or rebleeding were observed. ET is a better option for hemorrhage from oropharyngeal tumors than for hemorrhage from the main trunk of the carotid artery. The efficacy of ET is dependent on the vessels involved, and early identification of the culprit artery can predict the prognosis. ET should be considered an option for acute arterial hemorrhage in head and neck cancer.

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