Abstract
Rupture of the carotid artery is one of the most serious complications in the treatment of head and neck cancer, with a mortality rate of 40％. Here, we report four cases of carotid rupture related to head and neck cancer. All patients had recurrent head and neck cancer and were successfully rescued. In case 1, the common carotid artery ruptured due to intraoperative injury. The damaged artery was successfully repaired by primary suture. In cases 2 and 3, the common carotid artery ruptured due to postoperative wound infection. The carotid artery was eventually ligated in both cases. In case 4, a recurrent tumor markedly reduced in size with nivolumab administration, and as a result, the carotid artery was exteriorized and ruptured due to infection. The patient was successfully salvaged by stent placement. These cases indicate that the risk of carotid artery rupture should be carefully considered when choosing the treatment for recurrent head and neck cancer. A resuscitation program, including a multidisciplinary team approach, should be prepared for the possible risk of carotid rupture.
