Endovascular intervention in hemorrhage from oropharyngeal tumors: Case presentation of embolization of the lingual artery with coils

Oropharyngeal tumors represent a multidisciplinary challenge in terms of localization, potential local invasion, and associated symptoms. When patients present with active bleeding from the tumor, endovascular intervention may be essential to control the bleeding and stabilize the patient. Lingual neoplasm is a complex entity associated with significant morbidity, especially when it progresses with ulceration. In cases where the oropharyngeal tumor presents with active hemorrhage, endovascular embolization is an important therapeutic option for immediate hemorrhage control, thus contributing to hemodynamic stabilization and allowing the initiation of oncological treatment strategies.
This case report presents a 60-year-old chronic smoker with a known lingual neoplasm who presented to the emergency department with active oropharyngeal hemorrhage. On examination, the patient showed signs of significant bleeding from the base of the tongue and had an ECOG-PS of 3 (Eastern Cooperative Oncology Group Performance Status). Immediate intervention was necessary to control the bleeding and prevent further complications. After initial stabilization, the patient underwent angiographic evaluation, which identified active bleeding from the right lingual artery. Following the failure of conventional hemostatic methods, selective embolization of the lingual artery with permanent coil embolization material was decided. Post-procedural monitoring confirmed the absence of bleeding.
This case highlights the importance of prompt and precise multidisciplinary management of complex cases, which has a significant impact on patient outcomes. Initial management focused on hemorrhage control, which could impede the use of conventional oncological therapy known for its potential to negatively affect the healing process and tissue integrity. As an alternative to invasive surgical treatments and as a preliminary step in transitioning to oncological therapy, this paper recommends embolization as a valuable therapeutic option in similar circumstances. By effectively controlling hemorrhage, this procedure allows oncologists to proceed with cancer treatment strategies, minimizing delays and reducing the risk of further complications. Given the high incidence of smoking, increasing awareness and the use of these advanced interventional techniques are crucial for improving outcomes and reducing associated complications.