Esophageal cancer associated with chronic mucocutaneous candidiasis. Could chronic candidiasis lead to esophageal cancer?
Chronic mucocutaneous candidiasis (CMC) is a rare disease associated with immunodeficiency and characterized by persistent and refractory infections of the skin, appendages and mucous membranes caused by members of the genus Candida. Several different disorders are classified under this common denominator, including chronic and recurrent mucocutaneous infections due to Candida spp., which are sometimes linked to autoimmune endocrinopathies. These fungal infections are usually confined to the mucocutaneous surface, with little propensity for systemic disease or septicemia. We describe a patient with CMC who had an esophageal candidiasis refractory to treatment for decades and who developed an epidermoid esophageal cancer. No risk factors such as familiar susceptibility, smoking, alcohol drinking, or living in an endemic area were verified. This case report suggests the participation of nitrosamine compounds produced by chronic Candida infections as a risk factor for esophageal cancer in a patient with autosomal-dominant chronic mucocutaneous candidiasis.
Domingues-Ferreira
Mauricio
M
Laboratory of Medical Investigation in Dermatology and Immunodeficiencies, University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil. dmvascon@usp.br
Grumach
Anete Sevciovic
AS
Duarte
Alberto Jose Da Silva
AJ
De Moraes-Vasconcelos
Dewton
D
D000328:Adult; D002175:Candida; D002178:Candidiasis, Chronic Mucocutaneous / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D004938:Esophageal Neoplasms / Q000209:etiology*; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male