Case Reports in Oncological Medicine (Jan 2018)

Thoracic Endovascular Aortic Repair of Esophageal Cancer-Associated Aortoesophageal Fistula: A Case Report and Literature Review

  • Akiko Sasaki,
  • Hideto Egashira,
  • Shinnosuke Tokoro,
  • Chikamasa Ichita,
  • Satoshi Takizawa,
  • Toshitaka Tsukiyama,
  • Hidemitsu Ogino,
  • Jun Kawachi,
  • Rai Shimoyama,
  • Makoto Kako

DOI
https://doi.org/10.1155/2018/9851397
Journal volume & issue
Vol. 2018

Abstract

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Background. Thoracic endovascular aortic repair of an aortoesophageal fistula is an effective emergency treatment for patients with T4-esophageal cancer, as it prevents sudden death, and is a bridge to surgery. However, the course of unresectable malignant aortoesophageal fistula treated with thoracic endovascular aortic repair alone is not well-known. Case Presentation. We report a 67-year-old Japanese man with T4-esophageal cancer who experienced a chemoradiation-induced aortoesophageal fistula and was rescued with thoracic endovascular aortic repair. He recovered after the procedure and survived for 4 additional months with management of a mycotic aneurysm and secondary aortoesophageal fistula with the exposure of the stent graft into the esophagus. Thoracic endovascular aortic repair of aortoesophageal fistula with T4-esophageal cancer extended life for nearly an average of 4 months in the reported cases. As a postoperative complication, the exposure of the stent graft into the esophagus is rare but life-threatening; the esophageal stent insertion was effective. Conclusions. With postoperative management advances, thoracic endovascular aortic repair can improve survival and increase the quality of life of patients with T4-esophageal cancer.