Common carotid artery pseudoaneurysm after neck dissection: colour Doppler ultrasound and multidetector computed tomography findings

Abstract

Common carotid artery pseudoaneurysm is a rare disease, which has been previously unreported in association with neck dissection. We describe the Doppler ultrasound and multidetector computed tomography (CT) findings of a case of carotid pseudoaneurysm, one month after pharyngolaryngectomy with bilateral neck dissection. Multidetector CT confirmed the diagnosis made on the basis of Doppler ultrasound; the high image quality of axial and three-dimensional reconstructions avoided the need for pre-operative conventional angiography. In the presence of a pulsatile cervical mass after neck surgery, pseudoaneurysm of the carotid artery should be included in the differential diagnosis, and multidetector CT can be the sole pre-operative diagnostic imaging modality.

A false aneurysm

“…5 Four cases are reported to have arisen following radiotherapy used as singular therapy, two involving the internal carotid artery, 6,7 one involving the common carotid artery 7 and another involving the external carotid artery stump following ligation. There are three cases of pseudoaneurysms reported to have arisen following neck dissection, two involving the carotid bifurcation 3,4 and one involving the common carotid artery.…”

“…There are several documented case reports of pseudoaneurysms associated with neck dissection and radiotherapy used in the management of head & neck cancer. There are three cases of pseudoaneurysms reported to have arisen following neck dissection, two involving the carotid bifurcation 3 , 4 and one involving the common carotid artery 5 . Four cases are reported to have arisen following radiotherapy used as singular therapy, two involving the internal carotid artery, 6 , 7 one involving the common carotid artery 7 and another involving the external carotid artery stump following ligation 8 .…”