A rare cause of esophagopleural fistula due to intensity-modulated proton therapy: a case report and review of literature.

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Abstrakt

Tytuł:: A rare cause of esophagopleural fistula due to intensity-modulated proton therapy: a case report and review of literature.
Autorzy:: Ali O; University of Maryland Medical Center Midtown Campus, Baltimore, MD, 21201, USA.
Challa SR; University of Maryland Medical Center Midtown Campus, Baltimore, MD, 21201, USA.
Siddiqui OM; University of Maryland Medical Center, Baltimore, MD, 21201, USA.
Ali S; American University of Antigua College of Medicine, Coolidge, WI, Antigua and Barbuda.
Kim RE; University of Maryland Medical Center Midtown Campus, Baltimore, MD, 21201, USA. .; University of Maryland Medical Center, Baltimore, MD, 21201, USA. .; Department of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. .
Źródło:: Clinical journal of gastroenterology [Clin J Gastroenterol] 2021 Aug; Vol. 14 (4), pp. 955-960. Date of Electronic Publication: 2021 Apr 27.
Typ publikacji:: Case Reports; Journal Article; Review
Język:: English
Imprint Name(s):: Original Publication: [Tokyo] : Springer Japan
MeSH Terms:: Esophageal Fistula*/etiology
Pleural Diseases*/etiology
Pleural Diseases*/therapy
Proton Therapy*
Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local
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Grant Information:: T32 DK067872 United States DK NIDDK NIH HHS
Contributed Indexing:: Keywords: Chemoradiation; Endoscopy; Esophageal stent; Esophagopleural fistula; Pleural effusion
Entry Date(s):: Date Created: 20210427 Date Completed: 20210726 Latest Revision: 20220802
Update Code:: 20240105
PubMed Central ID:: PMC8316296
DOI:: 10.1007/s12328-021-01388-5
PMID:: 33905092
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Esophagopleural fistula (EPF), initially described in 1960, is an abnormal communication between the esophagus and the pleural cavity which can occur due to congenital malformation or acquired due to malignancy or iatrogenic treatment. The most common presenting symptoms are of a respiratory infection, such as fever, chest tenderness, cough and imaging findings consistent with pleural fluid consolidation. In this report, we present a 59-year-old man who exhibited shortness of breath, productive cough, and significant weight loss for 2 weeks. His medical history was significant for smoking-related lung disease and pulmonary squamous cell carcinoma (SCC). His SCC (T4N0) was diagnosed 6 years prior to this presentation and was treated with chemoradiotherapy. The cancer recurred a year ago and he was treated with intensity-modulated proton therapy (IMPT) and consolidation chemotherapy. During admission, he was found to have an EPF by CT scan after initially failing antibiotic treatment for suspected complicated pneumonia and pleural effusion. Multiple attempts of esophagopleural fistula closure were made using endoscopic self-expandable metallic stents and placement of an esophageal vacuum-assisted closure device. However, these measures ultimately failed and, therefore, he required an iliocostalis muscle flap (Clagett window) procedure for closure. Esophageal pulmonary fistulae should be suspected whenever patients have undergone thoracic IMPT and may present with acute pulmonary complications, particularly pneumonia refractory to antibiotic treatment. This case reviews the current literature, potential complications, and treatment options for esophagopleural fistulas.
(© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

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