External carotid artery (ECA) pseudoaneurysm is a known complication of treatment for head and neck cancer. We report a case of facial artery pseudoaneurysm arising after irradiation and salvage surgery for advanced tonsillar cancer, that was treated with endovascular embolization. The case was complicated by delayed transcutaneous extrusion of embolization coils through the skin of the anterior neck. We review the literature for related cases of coil extrusion in the head and neck, and discuss the implications for pseudoaneurysm surveillance.
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