Management of Aortoesophageal Fistula in a Palliative Patient with Non-Small-Cell Lung Cancer: A Case Report.

IF 2 4区 医学 Q3 ONCOLOGY Oncology Research and Treatment Pub Date : 2023-01-01 DOI:10.1159/000531250
Kathrin Adler, Ruben Evertz, Albrecht Neesse, Lorenz Biggemann, Tobias R Overbeck
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引用次数: 1

Abstract

Introduction: Aortoesophageal fistulas are a rare but life-threatening complication in patients with thoracic malignancies.

Case presentation: We describe a case of a 55-year-old female patient with metastatic non-small-cell lung cancer. Due to esophageal tumor compression, a fully covered self-expanding metal stent (fcSEMS) had been deployed in the esophagus several months before. The patient was subsequently admitted to the emergency department with massive hematemesis. Endoscopy suggested a fistula between the aorta and the esophagus proximal of the fcSEMS, which was confirmed by computed tomography and led to hemodynamical relevant upper gastrointestinal bleeding. A thoracic endovascular aortic repair was performed to stop the hemorrhage. After the successful intervention, the patient needed long-term antibiotic treatment, and the fcSEMS remained in place. Afterward, the patient continued palliative tumor therapy using pembrolizumab for further 5 months. The patient died 8 months after the initial admission to the emergency department.

Conclusion: This is to the best of our knowledge the first case of a technically successful interventional therapy of an aortoesophageal fistula which did not only achieve hemostasis but also enabled the patient to continue tumor therapy to regain quality of life.

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非小细胞肺癌姑息治疗患者主动脉食管瘘的处理:1例报告。
主动脉食管瘘是胸恶性肿瘤患者中一种罕见但危及生命的并发症。病例介绍:我们描述了一例55岁的女性患者转移性非小细胞肺癌。由于食管肿瘤压迫,几个月前在食管内放置了全覆盖自膨胀金属支架(fcems)。患者随后因大量呕血被送至急诊科。内镜提示主动脉与食管近端fcems之间有瘘,经计算机断层扫描证实,导致血流动力学相关的上消化道出血。进行了胸椎血管内主动脉修复术以止血。干预成功后,患者需要长期抗生素治疗,fcems保持原位。之后,患者继续使用派姆单抗进行姑息性肿瘤治疗5个月。患者于首次入急诊科8个月后死亡。结论:据我们所知,这是第一例技术上成功的主动脉食管瘘介入治疗,不仅实现了止血,而且使患者能够继续肿瘤治疗,恢复生活质量。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
84
期刊介绍: With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.
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