Tracheoesophageal Fistula Following Chemoradiation and Esophagectomy in Esophageal Adenocarcinoma: A Fatal Complication

TL;DR

A rare and deadly tracheoesophageal fistula occurred in a patient with esophageal cancer after treatment, highlighting the need for early detection and better management strategies.

Contribution

This case report highlights the rare but fatal complication of tracheoesophageal fistula following chemoradiation and surgery for esophageal adenocarcinoma.

Findings

Tracheoesophageal fistula can lead to severe complications like aspiration and bleeding.

Current treatment options for TEF remain limited and require a multidisciplinary approach.

Early diagnosis and tailored interventions are critical to prevent life-threatening outcomes.

Abstract

Tracheoesophageal fistula (TEF) is a rare but devastating complication that can arise in patients with esophageal cancer following multimodal therapy. We present the case of a 45-year-old male with stage III esophageal adenocarcinoma treated with neoadjuvant chemoradiation, followed by esophagectomy and immunotherapy. He subsequently developed a large TEF, resulting in recurrent aspiration, bleeding, and ultimately death despite comprehensive supportive measures. TEFs are associated with significant morbidity and mortality, and current therapeutic strategies remain limited. However, promising advances in endoscopic modalities and reconstructive surgery are emerging. Management necessitates a multidisciplinary, individualized approach, although standardized guidelines are currently lacking. Our case underscores the need for vigilance in patients at risk for TEF and the critical importance of early diagnosis and tailored intervention to prevent life-threatening complications.

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