CAROTID BLOWOUT SYNDROME FOLLOWING RADIOTHERAPY FOR NASOPHARYNGEAL CARCINOMA: A CASE REPORT AND LITERATURE REVIEW
Main Article Content
Abstract
Background: This case report describes a rare but catastrophic and life-threatening complication: Carotid blowout syndrome following radiotherapy for nasopharyngeal carcinoma. The condition necessitates early diagnosis and urgent management through a multidisciplinary approach.
Case Presentation: A 45-year-old female patient presented with massive epistaxis. Her medical history included nasopharyngeal carcinoma diagnosed 10 years prior, treated with multiple courses of chemoradiotherapy. Cerebral computed tomography angiography revealed a pseudoaneurysm at the C4 segment of the left internal carotid artery. The patient successfully underwent endovascular embolization, and no recurrent bleeding has been observed to date.
Conclusion: Carotid blowout syndrome following radiotherapy for nasopharyngeal carcinoma is a rare but lethal complication, characterized by massive hemorrhage that poses an immediate threat to life. Prompt diagnosis, urgent intervention, and rapid multidisciplinary coordination are imperative. Through this case report, we aim to provide an update on current diagnostic protocols and therapeutic strategies for post-radiation carotid blowout syndrome in nasopharyngeal carcinoma patients.
Keywords
Carotid blowout syndrome, nasopharyngeal carcinoma
Article Details
References
2. Yang Y, Peng X, Xu Y, Liu W, Zeng Z. Clinical features and CTA imaging of radiation-induced carotid pseudoaneurysms in nasopharyngeal carcinoma. BMC Med Imaging. 2026;26(1):18.
3. Zhao Z, Huang L, Chen J, Huang W, Zhang X, Ma Y, et al. Comprehensive Treatment Strategy for Internal Carotid Artery Blowout Syndrome Caused by Nasopharyngeal Carcinoma. Otolaryngol Head Neck Surg. 2021;164(5):1058-1064.
4. Lin Z, Chen J, Zou X, Zhang J, Huang D. Interventional Treatment Strategies for Carotid Blowout Syndrome After Radiotherapy for Nasopharyngeal Carcinoma. Cancer Manag Res. 2025;17:757-764.
5. Zeng L, Wan W, Luo Q, Jiang H, Ye J. Retrospective analysis of massive epistaxis and pseudoaneurysms in nasopharyngeal carcinoma after radiotherapy. Eur Arch Otorhinolaryngol. 2022;279(6):2973-2980.
6. Jiao H, Li H, Zhu Y, Chen H, Wang M, Liu T. Clinical analysis of intracranial and extracranial vascular bypass surgery for carotid blowout syndrome in nasopharyngeal carcinoma. Neurosurg Rev. 2025; 48(1): 324.
7. Wang Y, Dong X, Zhou C, Shi Q, Liu J, Xiong B. Endovascular Management of Intractable Nasopharyngeal Hemorrhage in Patients Irradiated for Nasopharyngeal Carcinoma: A Twelve-Year Experience. Cancer Manag Res. 2020; 12: 11943-11952.
8. Cheng HS, Lin TY, Twu CW, Lin PJ, Liu YC, Jiang RS, et al. Massive nasal bleeding in nasopharyngeal Carcinoma: Incidence, risk Predictors, and survival impact. Oral Oncol. 2025;167:107456.