# Aspergillus oesophagitis in a patient with solid tumors: a case report

## TL;DR

A rare case of Aspergillus oesophagitis is reported in an elderly patient with a history of multiple solid tumors, highlighting the need for early diagnosis and endoscopic evaluation.

## Contribution

This case report presents a rare occurrence of Aspergillus oesophagitis in a patient with solid tumors, not commonly seen in such populations.

## Key findings

- Aspergillus oesophagitis was diagnosed in a patient with a history of four solid tumors.
- The patient's symptoms persisted despite initial treatment, necessitating a repeat gastroscopy for accurate diagnosis.
- Aspergillus species were identified in the pericardial fluid before the patient's death.

## Abstract

Oesophageal aspergillosis is a rare occurrence primarily documented in hematologic malignancies, and only rarely occurring among patients with solid tumours. In this case report, we present the unique case of an 81-year-old Lebanese man who had a remarkable medical history, including four solid tumours. The patient sought medical attention due to dysphagia and weight loss, prompting a gastroscopic examination that revealed a necrotic abscess at the oesophagogastric junction. Initial treatment with fluconazole and esomeprazole was administered, but the recurrence of similar symptoms led to a repeat gastroscopy, unveiling a diagnosis of Aspergillus oesophagitis. Intravenous voriconazole was promptly initiated; however, the patient developed a significant pericardial effusion and expired, with Aspergillus species identified in the pericardial fluid prior to patient expiring. This exceptional case emphasizes the importance of considering oesophageal aspergillosis in cancer patients who present with refractory symptoms such as epigastric pain, dysphagia, nausea, and vomiting, despite symptomatic treatment. Our findings underscore the need for increased awareness and the inclusion of gastrointestinal endoscopy as part of the diagnostic approach for this rare but potentially life-threatening condition.