Yokota Keiichiro, Kitagawa Hiroyuki, Okamoto Ken, Namikawa Tsutomu, Maeda Hiromichi, Kobayashi Michiya, Seo Satoru
Department of Surgery, Kochi Medical School, Kochi, Japan.
Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan.
Cancer Diagn Progn. 2023 Jul 3;3(4):475-478. doi: 10.21873/cdp.10242. eCollection 2023 Jul-Aug.
BACKGROUND/AIM: We report a case of tracheo-esophageal fistula at a non-metastatic site during lenvatinib treatment of hepatocellular carcinoma with multiple bone metastases.
A 58-year-old male patient was diagnosed with hepatocellular carcinoma with multiple bone metastases and was treated with atezolizumab-bevacizumab. However, as the bone metastasis progressed, palliative radiation therapy was administered to the third thoracic vertebra, and lenvatinib was administered as a second-line treatment. The patient was hospitalized for aspiration pneumonia five months later. Chest computed tomography and bronchoscopy revealed a 5 cm tracheoesophageal fistula located 3 cm cranial to the carina. We diagnosed a benign tracheoesophageal fistula due to lenvatinib because his previous CT scan showed no metastases at the site of the fistula, and we performed esophageal bypass surgery 4 weeks after discontinuation of the lenvatinib.
To the best of our knowledge, this is the first case report of tracheoesophageal fistula at a nonmetastatic site during lenvatinib treatment for hepatocellular carcinoma.
背景/目的：我们报告了1例在使用乐伐替尼治疗伴有多发骨转移的肝细胞癌期间，在非转移部位发生气管食管瘘的病例。
一名58岁男性患者被诊断为伴有多发骨转移的肝细胞癌，并接受了阿替利珠单抗-贝伐单抗治疗。然而，随着骨转移进展，对第三胸椎进行了姑息性放射治疗，并给予乐伐替尼作为二线治疗。5个月后患者因吸入性肺炎住院。胸部计算机断层扫描和支气管镜检查显示，在隆突上方3 cm处有一个5 cm的气管食管瘘。由于患者之前的CT扫描显示瘘管部位无转移，我们诊断为乐伐替尼所致的良性气管食管瘘，并在停用乐伐替尼4周后进行了食管旁路手术。
据我们所知，这是首例关于乐伐替尼治疗肝细胞癌期间在非转移部位发生气管食管瘘的病例报告。
