Abstract:
Sarcomatoid carcinoma of the esophagus, a mixed tumor comprising both carcinomatous and sarcomatoid components and known as carcinosarcoma, is a rare malignancy. Clinically and radiologically, it presents like other esophageal cancers. Here we discuss the case of a 69-year-old male patient with sarcomatoid carcinoma of the esophagus who developed Stevens-Johnson syndrome (SJS) after chemotherapy with carboplatin and paclitaxel. The patient was evaluated for dysphagia and odynophagia. He was initially misdiagnosed to have an esophageal polyp and underwent excision for the same. He presented with recurrent growth at the local site, with histopathological examination showing sarcomatoid carcinoma of the esophagus. After the development of paclitaxel-carboplatin-induced SJS, the patient was subsequently treated with palliative radiotherapy at the primary site for symptomatic relief. He underwent feeding gastrostomy as a supportive nutritional measure and was on best supportive care after a multidisciplinary tumor board discussion. Paclitaxel-carboplatin-induced SJS poses numerous diagnostic conundrums, on account of there being only one reported incident prior to this in literature, to the best of our knowledge. In this report, we explore the diagnostic and therapeutic predicaments associated with a rare disease that is under-reported and understudied in literature and delve into the various treatment modalities that can benefit the patients. The case also demonstrates the delicate balance between cancer chemotherapeutics and their Pandora\'s box of adverse effects.
摘要:
食管肉瘤样癌,一种混合肿瘤,包括癌和肉瘤样成分,被称为癌肉瘤,是一种罕见的恶性肿瘤.临床和放射学,它表现得像其他食道癌。在这里,我们讨论了一名69岁的食管癌肉瘤样癌男性患者的病例,该患者在卡铂和紫杉醇化疗后发展为史蒂文斯-约翰逊综合征(SJS)。对患者进行吞咽困难和吞咽困难评估。他最初被误诊为食管息肉,并接受了切除手术。他介绍了当地的经常性增长,组织病理学检查显示食管肉瘤样癌。紫杉醇-卡铂诱导的SJS发展后,患者随后在原发部位接受姑息性放疗,以缓解症状.他接受了胃造口术作为一种支持性营养措施,并在多学科肿瘤委员会讨论后接受了最佳支持性治疗。紫杉醇-卡铂诱导的SJS提出了许多诊断难题,由于在此之前文献中只有一次报道的事件,据我们所知.在这份报告中,我们探讨了与文献报道不足和研究不足的罕见疾病相关的诊断和治疗困境,并深入研究了可使患者受益的各种治疗方式.该案例还证明了癌症化疗药物与其潘多拉不良反应之间的微妙平衡。