2017 Volume 42 Issue 1 Pages 32-39
A 66-year-old women admitted to our hospital because of left breast pain. She was performed core needle biopsy, and was diagnosed that her tumor was invasive lobular carcinoma of the breast, ER + / PgR- / HER2 1+ / Ki-67 30%. After complete evaluation, her tumor was deemed inoperable. Endocrine therapy was begun, but the effect was poor, thus, chemotherapy was initiated. She complained of severe coughing while drinking water and dysphagia 1 year later. Barium contrast esophagography showed a smooth, tapered narrowing at middle of the esophagus, and esophagoscopy revealed a circumferential stenosis without mucosal abnormality in the middle esophagus. Chest computed tomography scan showed esophageal wall thickness and stenosis of the middle thoracic esophagus, and she was diagnosed with esophageal metastasis. Dilatation by endoscopic balloon and metallic stent was performed, but stenosis was not relieved. After that, chest CT scan revealed esophagobronchial fistula. 6 months later, she had hematemesis, and an aortoesophageal fistula was identified by CT scan. She subsequently died of massive hematemesis and hemoptysis.
