A case of locally advanced mesopharyngeal carcinoma with bleeding from the internal carotid artery triggered by mucosal necrosis of the pharynx after induction chemotherapy and bioradiotherapy

Abstract

Radiation necrosis is an adverse event of radiotherapy in head and neck cancer that is sometimes refractory to treatment and difficult to treat. We herein report a case of locally advanced, unresectable, mesopharyngeal cancer treated with induction chemotherapy followed by bioradiotherapy, which resulted in pharyngeal mucosal necrosis and bleeding from the internal carotid artery after tumor disappearance and was successfully treated by stenting the internal carotid artery. Radiation necrosis in the head and neck region can lead to fatal complications when the tumor involves vital organs, such as the carotid artery, before treatment. To avoid serious complications, it is necessary to enact appropriate therapeutic measures, such as hyperbaric oxygen therapy and antibiotics, according to the infection status.