Recently, the Emergency Medicine Department of Xi'an International Medical Center Hospital performed tumor supply/bleeding artery embolization on a patient with a ruptured oropharyngeal malignant tumor, successfully "plugging" the lingual artery and bringing new hope to the patient.
Mr. Zhou is a patient with malignant tumors of the oropharynx, located at the base of the tongue and bilateral epiglottis. The lesions also involve bilateral palatine tonsils, pharyngeal walls, tongue muscles, vocal cords, and thyrohyoid muscles. I have been receiving radiation therapy. Not long ago, Mr. Zhou experienced symptoms of coughing and hemoptysis. Bleeding is one of the most common clinical symptoms in patients with malignant tumors, mainly caused by the erosion and destruction of surrounding blood vessels by tumor tissue. It has the characteristics of rapid onset, rapid disease changes, and high mortality rate.
After receiving the consultation, the chief resident physician of the emergency medicine department, Xi Haobo, immediately conducted a comprehensive evaluation of the patient. During radiotherapy, if patients experience tumor rupture and bleeding, they cannot continue with radiotherapy, and hemostasis is the top priority.
The tumor at the base of the patient's tongue can invade surrounding tissues such as the tonsils, pharyngeal wall, and tongue muscles. The "pharyngeal artery" has abundant blood supply, and there may be a dangerous anastomotic branch between the ascending pharyngeal artery and the vertebral artery. Once ectopic embolism occurs, it may bring catastrophic consequences to the patient. The surgery is difficult, and after fully informing the patient and their family of the necessity and risks of emergency intervention surgery and obtaining their informed consent, the emergency intervention team began intensive preoperative preparation work.
Under the guidance of DSA, the emergency intervention team quickly identified the tumor blood supply/bleeding target vessel located in the external carotid artery system and used a micro coil to seal the "lingual artery". At the same time as embolization of blood vessels to stop bleeding, the supply of tumor artery blood flow is interrupted, precise hemostasis complete "food shortage". This minimally invasive intervention treatment not only solves the current bleeding crisis, but also inhibits the blood supply of tumors, killing two birds with one stone in one surgery.
Interventional medicine has become the third largest treatment discipline alongside internal medicine and surgery, playing an important role in the treatment of hemorrhagic, thrombotic, and malignant tumors. Dr. Liu Xiaoman, Deputy Chief Physician of the Emergency Medicine Department, introduced that interventional therapy provides more options for patients with tumors that are difficult to remove by surgery or for patients whose condition cannot be controlled by conservative treatment in internal medicine. The patient in this case had a wide range of tumor invasion, including tonsils, pharyngeal wall, tongue muscle, vocal cords, and thyrohyoid muscle. Fortunately, the tumor had a relatively concentrated blood supply, so a vascular intervention method was chosen to leverage its advantages of minimal trauma and precise targeting.
After the surgery, the patient's vital signs remained stable, and there were no more signs of hemoptysis or other bleeding, which prolonged the patient's survival and improved their quality of life. At present, the patient is receiving regular radiation therapy.