title: Aortic pseudoaneurysm formation following concurrent chemoradiotherapy and metallic stent insertion in a patient with esophageal cancer.
abstract: Aortic pseudoaneurysm formation subsequent to concurrent chemoradiotherapy (CCRT) for esophageal cancer patient with esophageal metallic stent insertion is a rare condition.A 52-year-old man with esophageal cancer, cT4N1M0, stage IIIC, was treated with concurrent weekly cisplatin (30 mg/m) and 5-Fluorouracil (500 mg/m) as well as radiotherapy (50.4 Gy in 28 fractions) for 6 weeks. An esophageal metallic stent was inserted for dysphagia 1 week after initiation of CCRT. During the treatment regimen, the platelet count dropped to less than 200 × 10 /μL. One month after the completion of CCRT, chest CT revealed the presence of an aortic pseudoaneurysm as well as aortoesophageal fistulas. A thoracic aortic endografting was performed and the patient responded well to surgery. However, the patient died 2 months later due to a nosocomial infection.Multimodality treatment for esophageal cancer comprising cisplatin-based CCRT and esophageal metallic stent placement near a great vessel may increase the risk of pseudoaneurysm formation.
authors.affiliation: From the Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City (P-YH, P-WS, C-HH); Department of Medicine (C-JT, C-HH); Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei (C-HH); Division of Oncology and Hematology, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City (C-JT); Institute of Public Health, National Yang-Ming University, Taipei (C-JT); Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City (C-SC); College of Medicine, Fu Jen Catholic University, New Taipei City (C-SC); Department of Thoracic surgery, Far Eastern Memorial Hospital, New Taipei City (C-YL); Department of Medical Imaging, Far Eastern Memorial Hospital, New Taipei City (C-CH); Department of Anatomical Pathology, Far Eastern Memorial Hospital, New Taipei City (M-HC); Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (P-WS).
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Hou
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Teng
authors.forename: Chen-Shuan
authors.initials: CS
authors.lastname: Chung
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Huang
authors.forename: Miu-Hsiang
authors.initials: MH
authors.lastname: Chang
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Shueng
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
mesh_terms: D017541:Aneurysm, False / Q000209:etiology*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001018:Aortic Diseases / Q000209:etiology*; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000628:therapy*; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil