title: Delayed carotid blow-out syndrome: a new complication of chemoradiotherapy treatment in pharyngolaryngeal carcinoma.
abstract: BACKGROUND
  Carotid blow-out syndrome is one of the most devastating complications of head and neck carcinoma. It usually occurs as a post-operative complication or when the tumour compromises the vascular axis.
  
  
  RESULTS
  We report two patients who suffered carotid blow-out syndrome but who did not have the usual predisposing factors. Both patients had a pharyngolaryngeal carcinoma that was treated with chemoradiotherapy. Residual non-tumoural ulceration was seen along the lateral wall of the hypopharynx in both cases. This ulceration eventually reached the vascular axis, precipitating carotid rupture and death.
  
  
  CONCLUSIONS
  Residual non-tumoural ulceration of the lateral wall of the hypopharynx after chemoradiotherapy should be considered with the utmost caution. Once persistence of the tumour is excluded, surgery is indicated to protect the vascular axis, in order to prevent carotid blow-out syndrome.
authors.affiliation: Otorhinolaryngology Department, Hospital General de Catalunya, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Esteller
authors.forename: X
authors.initials: X
authors.lastname: León
authors.forename: M
authors.initials: M
authors.lastname: de Juan
authors.forename: M
authors.initials: M
authors.lastname: Quer
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000209:etiology* / Q000473:pathology; D059248:Chemoradiotherapy / Q000009:adverse effects*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D013577:Syndrome