An unusual case of tracheo-pleural fistula and cardiac metastases in oropharyngeal carcinoma: a case report and review of the literature.

Autor: Ferrari D; 1Medical Oncology, San Paolo Hospital, Milan, Italy.; 5San Paolo Hospital, via Di Rudinì 8, 20142 Milan, Italy., Codecà C; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Viale G; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Bocci B; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Broggio F; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Crepaldi F; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Violati M; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Luciani A; 1Medical Oncology, San Paolo Hospital, Milan, Italy., Bauer D; 2Division of Pathology, San Paolo Hospital, University of Milan Medical School, Milan, Italy., Moneghini L; 2Division of Pathology, San Paolo Hospital, University of Milan Medical School, Milan, Italy., Bulfamante G; 3Department of Medicine, Surgery and Dentistry, Division of Pathology, San Paolo Hospital, University of Milan Medical School, Milan, Italy., Foa P; 4Department of Oncology, Medical Oncology, San Paolo Hospital, University of Milan Medical School, Milan, Italy.
Jazyk: angličtina
Zdroj: Cancers of the head & neck [Cancers Head Neck] 2016 Dec 15; Vol. 1, pp. 16. Date of Electronic Publication: 2016 Dec 15 (Print Publication: 2016).
DOI: 10.1186/s41199-016-0018-5
Abstrakt: Background: Oropharyngeal cancer is frequently associated with human papilloma virus, that also represents a strong prognostic factor. Local relaps and treatment-related complications are frequent, whereas distant metastases occur in about 25% of patients.
Case Presentation: A 49 years-old male presented with a loco-regionally advanced oropharyngeal squamous cell carcinoma and was treated with concomitant chemoradiation. A complete clinical and pathological response was achieved, but the occurrence of necrotising tracheo-esophagitis, with tracheo-mediastino-pleural fistula formation, further complicated the subsequent clinical course. The patient died suddenly. Autopsy revealed multiple myocardial and epicardial metastases from oropharyngeal squamous cell carcinoma.
Conclusions: Even in case of a transient complete local response, the potential occurrence of severe complications and distant metastases, although infrequent, should be considered. Cardiac metastases are frequently underestimated, as they are often asymptomatic, but may lead to sudden death. Further efforts are needed to improve diagnosis and therapy in this setting.
Competing Interests: The authors declare that they have no competing interest.
Databáze: MEDLINE
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