Local Metastatic Neck Cancer Involving the Distal Internal Carotid Artery Treated with En Bloc Resection and Arterial Reconstruction after Mandibular Osteotomy

Head and neck cancers represent an aggressive form of neoplastic diseases that warrant surgical resection, in order to achieve optimal outcomes. Moreover, the involvement of the carotid artery is associated with a dismal prognosis and radical tumor resection becomes challenging. The current case report presents a patient with locally metastatic neck carcinoma attached to the right carotid bifurcation, involving both the external and internal carotid arteries up to the distal segment of the internal carotid artery (ICA) at the level of the C1 vertebra. The patient underwent en bloc tumor and vessel resection. The carotid artery was reconstructed using an interposition graft from the common carotid artery to the ICA by means of an autologous saphenous vein graft. A vertical mandibular osteotomy was performed, in order to expose the distal ICA. The postoperative recovery was uneventful. The patient was under follow-up for six months, without any signs of recurrence.