Superselectiye Embolization as Palliative Treatment of Recurrent Hemorrhage in Advanced Carcinoma of the Head and Neck

Abstract

We report a case of recurrent major hemorrhage in a patient with advanced head and neck squamous cell carcinoma. Before and between the bleeding episodes, the functional level of the patient was remarkably high. Therefore, an attempt at bleeding control with superselective embolization with Ethibloc was made. Because of its specific characteristics, this substance is almost ideal for the purpose of palliative embolization. The material used and the technique of application are described in detail. After the procedure, no hemorrhage occurred for more than 4 months. We recommend superselective embolization, preferably with Ethibloc, for minimally invasive control of recurrent bleeding as palliative treatment in selected patients with advanced head and neck carcinoma, since significant benefit in terms of the quality of life may result.

Keywords

head and neck carcinoma hemorrhage superselective embolization

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References

Wurm

Göde

Fucak

. Prophylaktische und notfallmäßige Unterbindungen der Aa. carotides bei Patienten mit malignen Tumoren im Kopf Hals-Gebiet. HNO 2000;48:22–7.

Fischbach

Lackner

Landwehr

Heindel

. Interventionelle Palliativtherapie. Zentralbl Chir 1998;123:703–13.

Neubauer

Derakhshani

Krug

Lackner

Heidenreich

Engelmann

. Posttraumatic high-flow priapism in a 10-year-old boy: Superselective embolization of the arteriovenous fistula. Eur Urol 1998;33:337–9.

Chatterjee

Heindel

Vorreuther

Engelmann

Lackner

. Recurrent bleeding of angiomyolipomas in tuberous sclerosis. Urol Int 1996;56:44–7.

Razack

Sako

. Carotid artery hemorrhage and ligation in head and neck cancer. J Surg Oncol 1982;19:189–92.

Wilner

Lazo

Metes

Beil

Nowack

Jacobs

. Embolization in cataclysmal hemorrhage caused by squamous cell carcinomas of the head and neck. Radiology 1987;163:759–62.

Morrissey

Andersen

Nesbit

Barnwell

Everts

Cohen

. Endovascular management of hemorrhage in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 1997;123:15–9.

Bhansali

Wilner

Jacobs

. Arterial embolization for control of bleeding in advanced head and neck carcinoma. J Laryngol Otol 1986;100:1289–93.

Valavanis

Christoforidis

. Applications of interventional neuroradiology in the head and neck. Semin Roentgenol 2000;35:72–83.

10.

Dion

. Principles and methodology. In: Vinuele

Halbach

Dion

, eds. Interventional neuroradiology: Endovascular therapy of the central nervous system. New York, NY: Raven, 1992:1–15.