Shaikh Bisma, Alam Muhammad Taha, Samad Shahzaib, Danishwar Mahmood
Jinnah Sindh Medical University, Karachi, Pakistan.
Reading Hospital-Towerhealth, Reading, PA, USA.
SAGE Open Med Case Rep. 2024 Aug 16;12:2050313X241266758. doi: 10.1177/2050313X241266758. eCollection 2024.
Esophageal cancer is extremely rare in pregnant women, accounting for only 0.07%-0.1% of all malignant neoplasms in pregnancy. It is rapidly progressive in nature and requires timely intervention. Our literature search yielded six case reports of esophageal cancers in pregnancy thus far. We herein report the case of a 30-year-old female, presenting at 32 weeks of gestation with complaints of hoarseness, dysphagia, and weight loss. The biopsy taken from within the esophagus, using an endoscope during an upper endoscopy procedure confirmed the diagnosis of squamous cell carcinoma of esophagus and Positron emission tomography-computed tomography revealed metastasis to parathyroid region. She was confirmed with metastatic squamous cell cancer positive for cytokeratin 5/6 and cytokeratin P40 immunohistochemistry. The Positron emission tomography-computed tomography of the chest showed a large hypermetabolic soft tissue mass in the mid-esophagus with significant proximal dilation. The head-and-neck computed tomography scan represented a necrotic nodal mass in the neck and circumferential mural thickening involving the mid-esophagus resulting in the proximal dilation confirming the primary tumor site. Two weeks after the delivery, the patient started a chemotherapy regimen consisting of nine cycles of Carboplatin and Paclitaxel. Postchemotherapeutic computed tomography showed remonstration of lesion in the thyroid gland and middle part of the esophagus. Thus, in pregnant patients with new onset hoarseness, dysphagia, or substantial weight loss, clinicians should keep esophageal cancer as part of their differentials. A thorough history, detailed physical examination, and imaging should be performed to determine esophageal cancer, as it can advance swiftly and has a poor prognosis if left untreated.
食管癌在孕妇中极为罕见，仅占孕期所有恶性肿瘤的0.07%-0.1%。其本质上进展迅速，需要及时干预。我们的文献检索迄今已获得6例孕期食管癌的病例报告。我们在此报告一例30岁女性病例，该患者在妊娠32周时出现声音嘶哑、吞咽困难和体重减轻的症状。在上消化道内镜检查过程中，通过内镜从食管内取材进行活检，确诊为食管鳞状细胞癌，正电子发射断层扫描-计算机断层扫描显示转移至甲状旁腺区域。她被确诊为转移性鳞状细胞癌，细胞角蛋白5/6和细胞角蛋白P40免疫组化呈阳性。胸部正电子发射断层扫描-计算机断层扫描显示食管中段有一个巨大的高代谢软组织肿块，近端明显扩张。头颈部计算机断层扫描显示颈部有一个坏死性淋巴结肿块，食管中段周壁增厚导致近端扩张，从而确定了原发肿瘤部位。分娩两周后，患者开始了一个由九个周期的卡铂和紫杉醇组成的化疗方案。化疗后的计算机断层扫描显示甲状腺和食管中部的病变有所缓解。因此，对于新发声音嘶哑、吞咽困难或体重显著减轻的孕妇，临床医生应将食管癌纳入鉴别诊断范围。应进行全面的病史询问、详细的体格检查和影像学检查以确诊食管癌，因为它进展迅速，若不治疗预后较差。
