Endovascular Treatment of a Carotid Artery Pseudoaneurysm in a Contaminated Wound: Report of a Case

We herein report a case of carotid artery pseudoaneurysm following intensive treatment for hypopharyngeal carcinoma. An81-year-old male had undergone surgery and concurrent chemoradiotherapy to treat hypopharyngeal carcinoma (T4aN1M0).This treatment led to a complete response, but pseudoaneurysms were formed at the external carotid artery in a contaminatedwound. One of the pseudoaneurysms was located close to the bifurcation and thus caused intractable hemorrhaging. We performedendovascular treatment to achieve hemostasis. One year after the embolization, surgical removal of the endovasculardevices from the infected area was performed. Three years have passed since the removal, and the patient is still alive withoutany complications. Primary endovascular treatment of an infected pseudoaneurysm could be an effective option for the treatmentof acute lethal hemorrhaging

Efficacy of Aprepitant for Nausea in Patients with Head and Neck Cancer Receiving Daily Cisplatin Therapy

Background: Although efficacy of aprepitant for suppressing emesis associated with single-dose cisplatin has been demonstrated, there are limited data on the antiemetic effect of this oral neurokinin-1 receptor antagonist during daily administration of cisplatin. Accordingly, we investigated the efficacy and safety of aprepitant in patients with head and neck cancer (HNC) receiving combination therapy with cisplatin and 5-FU (FP therapy). Materials and Methods: Twenty patients with HNC were prospectively studied who received a triple antiemetic regimen comprising granisetron (40μg/kg on Days 1-4), dexamethasone (8 mg on Days 1-4), and aprepitant (125 mg on day 1 and 80mg on days 2-5) with FP therapy (cisplatin 20 mg/m2 on days 1-4; 5-FU 400 mg/m2 on days 1-5) (aprepitant group). We also retrospectively studied another 20 HNC patients who received the same regimen except for aprepitant (control group). Results: For efficacy endpoints based on nausea, the aprepitant group showed significantly better results, including a higher rate of complete response (no vomiting and no salvage therapy) for the acute phase (p = 0.0342), although there was no marked difference between the two groups with regard to percentage of patients in whom vomiting was suppressed. There were no clinically relevant adverse reactions to aprepitant. Conclusions: This study suggested that a triple antiemetic regimen containing aprepitant is safe and effective for HNC patients receiving daily cisplatin therapy

Recurrent sebaceous carcinoma with wide intraepithelial spread to the nasal cavity: Report of two cases

Background: Sebaceous carcinoma (SC) is a relatively rare tumor that usually arises from the eyelid. Local extension down the nasolacrimal duct is relatively rare event for SC.Method: We herein report two cases of recurrent SC in the nasal cavity. Both patients had previously received primary treatment for SC of the eyelid. Seven years after the initial treatment, the first patient presented with a mass on the left medial canthus of the eyelid. Sixteen months after the initial treatment, the second patient presented with a large mass in the right nasal cavity.Results: The wide intraepithelial spread of SC over 30 mm from the initial surgical margin was beyond our expectations. The first patient is currently alive with local recurrence following the administration of chemoradiotherapy 46 months after treatment, while the second patient died of distant metastasis.Conclusion: This report focuses on the unique clinical features of intranasal recurrence of SC after treatment