Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T17:28:53.973Z Has data issue: false hasContentIssue false
  • English
  • Français

A false aneurysm

Published online by Cambridge University Press:  30 March 2012

D Mitchell ,
C Repanos  and
W B Coman
D Mitchell
Affiliation:
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
C Repanos*
Affiliation:
Department Head and Neck Surgery, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
W B Coman
Affiliation:
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
*
Address for correspondence: Mr Costa Repanos, ENT Department, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Ports mouth, UK, P06 3LY E-mail: costa@repanos.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We report a case of a remaining hemi-thyroid following laryngectomy, which was misinterpreted as a pseudoaneurysm.

Methods:

Case report and comment on this understandable error which is easily avoidable.

Results:

A 59-year-old man had undergone salvage laryngectomy for recurrent squamous cell carcinoma of the larynx, which had previously been treated with radiotherapy. Three months after his laryngectomy, he presented with a sore neck and subcutaneous collections. Computed tomography revealed a unilateral mass with high signal contrast uptake anterior to the left common carotid artery, which was thought initially to be a carotid pseudoaneurysm. Further investigation, including ultrasonography and a review by the senior head and neck radiologist, demonstrated that this mass was actually the remnant hemi-thyroid preserved at laryngectomy (which is often misshapen compared with a normal hemi-thyroid). The collections were found to be recurrent tumour, and unnecessary further interventions were avoided.

Conclusion:

Ultrasonography easily distinguishes between a thyroid remnant and a pseudoaneurysm. Furthermore, the opinion of an experienced head and neck radiologist may be vital when interpreting complex post-surgical head and neck radiology.

Keywords

PseudoaneurysmSquamous Cell CarcinomaFalse AneurysmUltrasound
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 126 , Supplement S2 , July 2012 , pp. S14 - S15
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Cummings, CW. Otolaryngology Head & Neck Surgery 2005;16:3692–3Google Scholar
2Nadig, S, Barnwell, S, Wax, MK. Pseudoaneurysm of external carotid artery – review of literature. Head Neck 2009;31:136–9CrossRefGoogle ScholarPubMed
3Iguchi, H, Takayama, M, Kusuki, M, Nakamura, A, Kanazawa, A, Hachiya, K et al. Carotid artery pseudoaneurysm as a sequela of surgery for laryngeal cancer. Acta Otolaryngol 2006;126:557–60CrossRefGoogle ScholarPubMed
4Girishkumar, T, Sivakumar, M, Andaz, S, Santosh, V, Solomon, R, Brown, M. Pseudo-aneurysm of the carotid bifurcation secondary to radiation. J Cardiovasc Surg (Torino) 1999;40:877–8Google ScholarPubMed
5Flor, N, Sardanelli, F, Ghilardi, G, Tentori, A, Franceschelli, G, Felisati, G et al. Common carotid pseudoaneurysm after neck dissection: colour Doppler ultrasound and multidetector computed tomography findings. J Laryngol Otol 2007;121:497–500CrossRefGoogle ScholarPubMed
6Cheng, KY, Lee, KW, Chiang, FY, Ho, KY, Kuo, WR. Rupture of radiation induced internal carotid artery pseudoaneurysm in a patient with nasopharyngeal carcinoma – spontaneous occlusion of carotid artery due to long term embolizing performance. Head Neck 2008;30:1132–5CrossRefGoogle Scholar
7Chen, HC, Lin, CJ, Jen, YM, Juan, CJ, Hsueh, CJ, Lee, JC et al. Ruptured internal carotid pseudoaneurysm in a nasopharyngeal carcinoma patient with skull base osteoradionecrosis. Otolaryngol Head Neck Surg 2004;130:388–90Google Scholar
8Maruyama, Y, Arai, K, Hoshida, S, Yoneda, K, Furukawa, M, Yoshizaki, T. Case of three delayed complications of radiotherapy: bilateral vocal cord immobility, esophageal obstruction and ruptured pseudoaneurysm of carotid artery. Auris Nasus Larynx 2009;36:505–8CrossRefGoogle ScholarPubMed
9Tanaka, S, Kimura, Y, Furukawa, M. Pseudoaneurysm of the carotid artery with haemorrhage into the hypopharynx. J Laryngol Otol 1995;109:889–91Google Scholar
10Minion, DJ, Lynch, TG, Baxter, BT, Lieberman, R. Pseudoaneurysm of the external carotid artery following radical neck dissection and irradiation: a case report and review of literature. Cardiovasc Surg 1994;2:607–11Google Scholar