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Bleeding after interstitial brachytherapy for cervical cancer requiring embolization.

Vanya Aggarwal1, Anthony Chuprin2, Abhimanyu Aggarwal2

  • 1George Washington University School of Medicine, 2300 I St NW, Washington, DC 20052, USA.

Radiology Case Reports
|September 21, 2018
PubMed
Summary

A cervical cancer patient experienced vascular injury during brachytherapy due to needle malposition. Arterial embolization successfully treated the bleeding, marking the first reported case of this complication requiring intervention.

Keywords:
BleedingCervical cancerEmbolizationInterstitial brachytherapy

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Area of Science:

  • Gynecologic Oncology
  • Interventional Radiology
  • Radiation Oncology

Background:

  • Cervical cancer is a significant global health concern, particularly in advanced stages.
  • Chemoradiation is a standard treatment for advanced cervical cancer.
  • Brachytherapy, including interstitial techniques, is used for local disease control.

Observation:

  • A 41-year-old female with locally advanced cervical cancer experienced a complication during her fifth brachytherapy session.
  • An interstitial needle became malpositioned, resulting in significant vascular injury and hemorrhage.
  • The injury involved a branch of the right obturator artery.

Findings:

  • The patient required emergent arterial embolization to achieve hemostasis.
  • The embolization procedure was successful, leading to immediate clinical improvement.
  • This represents the first documented case of vascular injury from an interstitial brachytherapy needle necessitating arterial embolization.

Implications:

  • This case underscores the importance of meticulous technique and vigilance during interstitial brachytherapy placement.
  • It highlights the critical role of interventional radiology in managing rare but severe complications.
  • Awareness of potential vascular injury and preparedness for emergent embolization are essential for patient safety in advanced cervical cancer treatment.