Reactions 1680, p82 - 2 Dec 2017 Tracheoesophageal fistula: case report A 72-year-old man developed tracheoesophageal fistula following treatment with carboplatin and gemcitabine [routes and dosages not stated]. The man, who had a history of stage IV squamous lung cancer, was hospitalised with four week history of shortness of breath, anorexia and increased haemoptysis. He was diagnosed with lung cancer eight years ago and was treated with combined radiation and chemotherapy leading to progression-free seven years. However, the cancer reoccurred one year ago. He was treated with four cycles of palliative chemotherapy consisting of carboplatin and gemcitabine. However, one month before the current hospitalisation, he developed pain in right side of chest, progressive haemoptysis and fatigue. After hospitalisation, chest X-ray was taken, which revealed left lung base with worsened reticular markings indicating an infection. The chest CT findings were suggestive of an interval progression of malignancy with an area of consolidation along the medial right lower lung. Sputum culture revealed mixed bacterial growth [duration of treatment to reaction onset not clearly stated]. The man was treated with antibacterials and palliative radiation therapy. Immediately after completion of eight cycles of radiation therapy, the man developed shortness of breath, progressive coughing, fever, difficulty in swallowing and confusion. He was readmitted. His chest X-ray revealed bilateral lung bases with increased interstitial prominence. Laboratory examination revealed WBC count of 21.2 x 10 /L suggestive of an infection. Procalcitonin level was 0.12 ng/mL. A diagnosis of hospital acquired pneumonia was made. He again received antibacterials. Sputum culture showed unidentified polymicrobial growth. A video swallow evaluation revealed tracheoesophageal fistula in the middle third of the oesophagus. He successfully underwent a palliative oesophageal stent placement and upper endoscopy. He tolerated diet without any complications and was sent for further hospice care. Author comment: "We here report a case of a 72-year-old male who developed a [tracheoesophageal fistula] upon re- irradiation of squamous cell cancer 1 year after treatment with gemcitabine/carboplatin." "This case highlights the role of radiotherapy and chemotherapy on development of [tracheoesophageal fistula] on the setting of lung cancer." Abugroun A, et al. Late onset chemo/radiation induced tracheoesophageal fistula in squamous cell cancer of the lung. World Journal of Oncology 8: 171-173, No. 5, Oct 2017. Available from: URL: http://doi.org/10.14740/wjon1063w - USA 803284596 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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