Delayed aortic rupture after radiochemotherapy and esophagectomy for esophageal cancer.
Spontaneous rupture of major vessels is a known though rare complication in treatment of patients with esophageal cancer, but its pathophysiology is not very well understood. We herein report about the sudden death of a 42-year-old man due to spontaneous aortic rupture, 11 days after transthoracic esophagectomy. Because of a locally advanced squamous cell carcinoma of the distal esophagus, which was considered irresectable at the time of presentation, the patient had received one course of chemotherapy followed by synchronous chemoradiation (60 Gy, 5-fluorouracil and cisplatin) prior to surgery. We discuss the patho-anatomic findings of the postmortem examination concerning alterations of the aortic wall and the potential correlations with aggressive radiochemotherapy protocols.
von Rahden
B H A
BH
Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Germany. vrahden@nt1.chir.med.tu-muenchen.de
Stein
H J
HJ
Reiter
R
R
Becker
I
I
Siewert
J R
JR
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001019:Aortic Rupture / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011878:Radiotherapy / Q000009:adverse effects*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D013997:Time Factors
D000970:Antineoplastic Agents