Department of General Medicine, the Affiliated Hospital of Qingdao University, Qingdao, China,Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao, China.
Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029045.
Esophageal stenosis after chemotherapy in breast cancer patients is rare. Distinguishing esophageal stenosis from esophageal metastasis caused by breast cancer is important.
A 62-year-old woman diagnosed with advanced breast cancer and no distant metastases gradually developed skin changes, oral ulcers and mucosal injures after four cycles of chemotherapy. Dysphagia was the most severe symptom that greatly affected the patient's quality of life. Ultimately, esophageal stenosis and ulceration were confirmed by serial radiological examinations and endoscopic biopsy.
Due to difficulties in eating orally, the patient was initially placed on a nasogastric tube in order to improve her nutritional status. Simultaneously, she was administered powerful proton pump inhibitors. She underwent modified radical mastectomy for breast cancer after her nutritional status improved. However, the patient was still suffering from severe dysphagia after more than 4 months of follow-up. Subsequently, she underwent removable esophageal stent implantation after after unsuccessful attempts to dilate her esophagus.
The dysphagia symptoms were immediately alleviated to a certain degree, and the dilated cavity of the upper esophagus showed slight retraction.
Esophageal stenosis is very infrequent in patients with breast cancer after chemotherapy. It needs to be. distinguished from esophageal metastasis caused by breast cancer. Esophageal stent implantation may provide benefits in terms of both symptom control and survival in patients with severe esophageal structures.
乳腺癌患者化疗后发生食管狭窄较为罕见。区分由乳腺癌引起的食管狭窄和食管转移非常重要。
一名 62 岁女性，被诊断为晚期乳腺癌且无远处转移，在接受了四个周期的化疗后逐渐出现皮肤改变、口腔溃疡和黏膜损伤。吞咽困难是最严重的症状，极大地影响了患者的生活质量。最终，通过连续的影像学检查和内镜活检证实了食管狭窄和溃疡。
由于患者经口进食困难，最初给予鼻胃管以改善营养状况。同时，给予强效质子泵抑制剂。患者的营养状况改善后，进行了乳腺癌改良根治术。然而，在随访超过 4 个月后，患者仍存在严重的吞咽困难。随后，在食管扩张失败后，患者接受了可移除食管支架植入术。
吞咽困难症状得到了一定程度的缓解，上食管扩张腔显示出轻微回缩。
乳腺癌化疗后发生食管狭窄非常罕见，需要与乳腺癌引起的食管转移相区分。对于严重的食管结构狭窄患者，食管支架植入可能在症状控制和生存方面带来获益。
