A 40-year-old male with history of HIV infection was admitted to the hospital with a one-month history of productive cough, vespertine fever, night sweats, loss of appetite and unintentional 10-Kg weight loss. Physical exam was remarkable for cachexia. Blood tests revealed a CD4+ T lymphocyte count of 23 cells/mm3 and HIV viral load of 837,678 copies/ml. Bacilloscopies were positive. Chest computed thomography (CT) showed multiple mediastinal lymph nodes, signs of esophagomediastinal fistula, pericardial effusion and multiple micronodular pulmonary opacities. Endoscopy (EGD) revealed a 10 mm deep ulcer-like lesion in the middle esophagus with pus overflow, but no bubbles were seen. The diagnosis of stage C3 HIV infection with disseminated tuberculosis was made and the patient underwent standard antituberculosis (RIPE) and antiretroviral therapy. Given the mediastinitis risk a percutaneous endoscopic gastrostomy (PEG) tube was placed for nutritional purposes.
* A case study of a 44-year-old male with advanced non-small cell lung cancer (NSCLC) demonstrates the challenges of managing complications from ICI treatment, including serious side effects and COVID-19 infections that affected his treatment outcomes.
* While facing significant health issues, the patient experienced unexpected tumor regression and resolution of complications, suggesting that COVID-19 could potentially have beneficial antitumor effects, leading to new considerations for cancer treatment strategies.
The First College of Clinical Medical Science, China Three Gorges University, Yichang, China; Institute of Digestive Disease, China Three Gorges University, Yichang, China; Department of Gastroenterology, Yichang Central People's Hospital, Yichang, China. Electronic address:
Tuberculosis is a primary lung disease that can spread to the lymph nodes, vertebrae, and gastrointestinal tract. The esophagus can be affected by mediastinal lymphadenitis, mostly in immunocompromised patients, leading to the formation of esophagomediastinal fistulas. They can cause dysphagia, pleuritic chest pain, and choking coughs from recurrent aspiration.
Radical gastrectomy for gastric cancer results in various post-operative complications, and the influencing factors are complicated. The diagnosis, treatment and prevention of common complications have been reported in many literatures. However, there are few reports on the prevention and treatment of rare complications.
Objective: Retrospectively analyzed the esophageal carcinoma (EC) patients with esophageal perforation (EP) after radiotherapy to discuss the treatment and prognosis.
Methods: Data of patients with EC who had EP after radiotherapy in Hebei Cancer Hospital were collected from 2001 to 2020 and retrospectively analyzed. All analyses were performed using SPSS Statistics for Windows, version 18.
