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. 2013:2013:379039.
doi: 10.1155/2013/379039. Epub 2013 Jun 1.

Radiation-induced carotid artery stenosis in a patient with carcinoma of the oral floor

Kahori Seto  1 , Kenji Yamagata, Fumihiko Uchida, Toru Yanagawa, Kojiro Onizawa, Hiroki Bukawa
Affiliations

Radiation-induced carotid artery stenosis in a patient with carcinoma of the oral floor

Kahori Seto et al. Case Rep Oncol Med. 2013.

Abstract

Radiation-induced carotid artery stenosis (RI-CS), a life-threatening condition, can occur after external radiation for head and neck cancer. We here describe a case of asymptomatic RI-CS in a 73-year-old patient treated with chemoradiotherapy and radical neck dissection for a basaloid squamous cell carcinoma of the oral floor. Stenosis of the left carotid artery, diagnosed as RI-CS, showed on an MRI performed 1.5 years after radiotherapy. Blood from the left side of the anterior cerebral artery and the middle anterior artery was flowing to the brain through the anterior and posterior communicating arteries, so no stent surgery or other treatment was necessary. The cancer has not recurred during approximately 5 years of followup after radiotherapy, and the patient has had no adverse effects from the RI-CS since it was diagnosed 3.5 years ago. This case emphasizes the necessity of early scrutiny for RI-CS in patients given radiotherapy for oral cancer.

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Figures

Figure 1
Figure 1
Examination showed a 22 × 15 mm mass with a granular surface in the middle of the mouth floor.
Figure 2
Figure 2
Lobulate or papillary alveolar forms were constructed by epithelial-like and basaloid tumor cells. These cells showed peripheral palisading, hyperchromatic nuclei with a high N/C ratio, and frequent mitosis (HE, ×100 and ×400).
Figure 3
Figure 3
MR imaging (T2). (a) A flow void at the left carotid artery was observed immediately after radiotherapy. (b) No flow void was seen 1.5 years after radiotherapy, suggesting occlusion of the carotid artery.
Figure 4
Figure 4
MRA showed an occluded carotid artery 1 cm from the origin (arrows). The anterior and middle cerebral arteries were being nourished through the anterior and posterior communicating arteries. A comm A: anterior communicating artery, ACA: anterior cerebral artery, P comm A: posterior communicating artery, BA: basilar artery, CCA: common carotid artery, ICA: internal carotid artery, ECA: external carotid artery, MCA: middle cerebral artery, and VA: vertebral artery.
See this image and copyright information in PMC

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