방사선치료 후 비출혈로 나타난 추체내경동맥의 가성동맥류 1예
A case of petrous carotid artery pseudoaneurysm presenting with epistaxis after radiotherapy in a patient with nasopharyngeal cancer
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비인두암으로 동시 항암방사선치료를 받았던 환자가 2개월 전부터 청력저하와 두통을 호소하였고, 비출혈이 있어 응급실에 내원하였다. CT상 좌측 경동맥의 가성동맥류가 의심되어 혈관조영술을 시행하였고, 이로써 가성동맥류를 확진하였다. 이후 코일을 이용하여 좌측 경동맥 폐색술을 시행하였고, 이후 환자의 증상은 호전되었다. 방사선치료를 받은 비인두암 환자에서 내경동맥 가성동맥류의 발생은 그 빈도가 매우 적으며, 현재까지 한국에서 보고된 바 없기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Rupture of an internal carotid artery pseudoaneurysm is a rare but lethal complication in patients with nasopharyngeal cancer. Here, we report a case of severe nasal bleeding from a left petrous internal carotid artery aneurysm after chemoradiotherapy in a patient with nasopharyngeal cancer. A 76-year-old man who was being treated with concurrent chemoradiotherapy and who had achieved a complete response for 14 months developed massive epistaxis . A postnasal space computed tomography scan showed an enhanced nodular lesion at the left petrous internal carotid artery, and angiography revealed a pseudoaneurysm measuring 11.5×9.1 mm in the left internal carotid artery. Bleeding was well controlled with endovascular occlusion using a coil. The patient showed no recurrence of bleeding during follow-up.
참고문헌 (8)
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