# Case Report: The huge esophageal displacement: a case of dramatic esophageal interfraction motion during neoadjuvant chemotherapy and immunotherapy

## TL;DR

A 72-year-old man with advanced esophageal cancer experienced a 4.2 cm shift in esophageal position after two cycles of chemotherapy and immunotherapy.

## Contribution

This case report highlights an unusual and large esophageal displacement during neoadjuvant treatment, which is rarely documented.

## Key findings

- The esophagus shifted 4.2 cm radially from right to left after two treatment cycles.
- Such dramatic esophageal motion is uncommon and may impact radiotherapy planning.
- The case emphasizes the need for monitoring esophageal movement during treatment.

## Abstract

The average movement of esophagus is about 0.15 to 0.4 cm radially and 0.3 to 0.9 cm in the superior-inferior during radiotherapy. Little study has reported giant shift of esophagus during neoadjuvant chemotherapy and immunotherapy.

Here we presented a case of a 72-year-old male patient diagnosed with advanced lower thoracic esophageal squamous cell cancer, clinical T2N2M1, stage IVB (pulmonary metastasis). The esophagus moved about 4.2 cm radially from the right to the left of the aorta after 2 cycles of chemotherapy and immunotherapy.

All in all, we treated a patient with advanced lower thoracic esophageal squamous cell cancer that occurred a dramatic radial escape of about 4.2 cm after 2 cycles of chemotherapy and immunotherapy.