Esophageal-meningeal fistula after anterior cervical corpectomy, stereotactic body radiation therapy (SBRT), and bevacizumab-containing systemic therapy for metastatic epidural spinal cord compression (MESCC)

Abstract

Metastatic epidural spinal cord compression (MESCC) is a common complication of malignancy. Surgical decompression and stabilization are commonly undertaken to prevent mechanical instability and deformity, relieve neurologic compression, and facilitate stereotactic body radiation therapy (SBRT). We report a case of an esophageal-meningeal fistula following anterior cervical corpectomy, SBRT, and bevacizumab-containing systemic therapy for MESCC. Esophageal-meningeal fistulae have been rarely reported following injury to the esophagus and dura at the time of surgery or in a delayed manner secondary to hardware failure. Our report is the first to highlight that, in the absence of such injury, anterior decompression can still create the possibility of esophageal-meningeal fistula in the treatment field.

Keywords

• Metastatic epidural spinal cord compression
• Stereotactic body radiation therapy
• Esophageal-meningeal fistula