Hypopharyngeal cancer with aplastic anemia

Abstract

Aplastic anemia (AA) is an intractable hematological disease in which the hematopoietic capacity of all blood cell lines, including erythrocytes, granulocytes, and megakaryocytes, in the bone marrow is quantitatively or functionally reduced, resulting in pancytopenia. We report a case of hypopharyngeal cancer complicated by aplastic anemia. The patient also had esophageal cancer, and radiation therapy was selected for both hypopharyngeal cancer and esophageal cancer considering the bleeding tendency. After starting treatment, myelosuppression progressed and the patient's condition was complicated by infection, which made it difficult to continue radiotherapy. Therefore, radiotherapy was discontinued. The patient's hypopharyngeal cancer showed a complete response, but their esophageal cancer persisted. Radiotherapy was restarted to treat the esophageal cancer, but was discontinued midway due to infection associated with bone marrow suppression. Thereafter, the patient was hospitalized for Pseudomonas aeruginosa bacteremia, and although the infection improved, he developed epistaxis and died of hemorrhagic shock. The choice of treatment for a malignant tumor associated with aplastic anemia should be considered in consideration of the severity of the aplastic anemia, the extent of the malignant tumor, and the presence or absence of multiple cancers, and surgery should be selected based on the responsiveness to blood transfusion.