Abstract
A 58-year-old man who was diagnosed as having synchronous double cancer, including advanced esophageal cancer and superficial hypopharyngeal cancer, was administered neoadjuvant chemoradiotherapy (CRT). He had sudden onset of left chest pain after several bouts of vomiting on the 8th day after the initiation of CRT. A chest computed tomography scan revealed emphysema localizing in the lower mediastinum, and an esophagoscopy found perforation 2 cm in longer diameter on the left side wall at the lower esophagus where was 3 cm proximal to the esophagogastric junction. Spontaneous esophageal perforation due to vomiting was diagnosed. Immediately an esophageal covered metal stent was placed and he was treated conservatively. Since his condition recovered without complications, we resumed the CRT on 16th day after perforation. We converted the treatment strategy to definitive CRT and completed it. The stent was removed on the 47th day after the esophageal perforation. The esophageal perforation was cured and the tumor disappeared completely, that was judged to be a complete response. He has been followed in our out-patient clinic without recurrent disease, as of one year after the therapy.
