Multimodal endovascular palliation for femoral arterial blowout in the setting of metastatic vulvar carcinoma

Ann Vasc Surg. 2015 Jan;29(1):127.e11-5. doi: 10.1016/j.avsg.2014.08.012. Epub 2014 Oct 8.

Abstract

Background: Vascular blowout syndrome is a well-known, life-threatening condition complicating advanced-stage head and neck malignancies but has rarely been reported in the gynecologic oncology realm in association with the femoral circulation. A 50-year-old woman with metastatic vulvar squamous cell carcinoma presented with left threatened femoral arterial blowout, secondary to an exophytic neoplastic mass originating from the left inguinal lymph nodes.

Methods: Bland embolization of the tumor as well as 3 vessel covered stent revascularization was successfully performed with excellent tumor devascularization and reinstitution of arterial integrity.

Results: Successful devascularization of the tumor, with no non-target embolization was achieved, with excellent apposition and deployment of 3 covered stents in the femoral artery bifurcation.

Conclusion: We present a unique case of threatened femoral artery blowout syndrome in the setting of metastatic vulvar carcinoma requiring various endovascular techniques for palliation. These endovascular techniques can be invaluable in minimally invasive palliation of advanced stage neoplasms abutting the iliofemoral circulation.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon / instrumentation
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / secondary*
  • Combined Modality Therapy
  • Embolization, Therapeutic*
  • Female
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / pathology*
  • Humans
  • Lymph Nodes / pathology*
  • Middle Aged
  • Neoplasm Invasiveness
  • Palliative Care
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / etiology
  • Peripheral Arterial Disease / therapy*
  • Rupture, Spontaneous
  • Stents
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vulvar Neoplasms / pathology*