Minimally invasive radiologic approach to chyle leakage after oncologic cervical surgery: A case report

A 63-year-old male smoker developed a refractory cervical chylous fistula following neck surgery for metastatic squamous cell carcinoma. Despite conservative management with a low-fat diet and subsequent surgical thoracic duct ligation, high-output chyle drainage persisted. On postoperative day 14, percutaneous thoracic duct embolization with lipiodol and n-BCA was successfully performed, resulting in immediate and sustained resolution of the leakage. The patient was discharged 48 hours later without recurrence. This case highlights thoracic duct embolization as a safe, minimally invasive, and highly effective therapeutic option for managing persistent cervical chylous fistulas when conventional treatments fail. The novelty of this report lies in demonstrating that timely image-guided embolization can provide definitive resolution even in severe, surgery-resistant cases, underscoring its growing role as a first-line intervention in selected patients.