A case of papillary thyroid carcinoma with esophageal invasion treated by targeting PEI and transesophageal argon plasma coagulation
M. Nakano & N. Fukunari
There are several choices for treating esophageal cancer. But only operation is the standard therapy of papillary thyroid carcinoma with esophageal invasion. Esophageal stent and gastric fistula are chose when the patient cant swallow because of esophageal stenosis by tumor invasion. But those put a lot of strain on the patient, and lower their quality of life. To reduce the burden on patient, it is useful to adopt targeting percutaneous ethanol injection (targeting PEI) and transesophageal argon plasma coagulation (APC). Targeting PEI can reduce the volume of main tumor with cutting off feeding artery. APC is used treating benign esophageal disease like a varix generally. Recently, it began to be used for treating early esophageal cancer, and some reports say it is effective treatment for tracheal invasion of head and neck tumor. We present a patient of Papillary Thyroid Carcinoma (PTC) with esophageal invasion who kept prognosis well with treatment of targeting PEI and transesophageal APC. The patient was 83 years old woman who complained dysphagia. There was a tumor at right lobe of the thyroid gland, its size was 30×29×24 mm. Lung metastasis and invasion to esophagus and trachea were found by CT. Endoscopic examination detected globular tumor 20 cm away from front tooth, and it occupied 80% of esophageal lumen. We treated main tumor with Targeting PEI twice. After treatment, the size was reduced about 22×17×16 mm. Next, we treated esophageal invasion with APC and PEI. After first time treatment, its size reduced to 50% of lumen. Total 5 times we did, and its size reduced to 20% finally. It has been about 40 months from last treatment, no any problems appeared.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.