Respir Case Rep. 2022; 11(3): 119-122 | DOI: 10.5505/respircase.2022.70846

Tracheoesophageal Fistula Associated with Nivolumab

Ayþe Bahadýr, Sibel Yurt, Mehmet Akif Özgül, Muhammet Atýf Karagöl, Levent Arafat
Çam ve Sakura City Hospital, Ýstanbul, Türkiye

Tracheoesophageal fistula (TEF) is a pathological connection between the trachea and the esophagus that can be congenital or can develop in older ages as a result of benign or malignant causes. It develops as a result of mediastinal invasion or after chemoradiotherapy in lung and esophageal cancers, and is associated with high mortality and morbidity. TEF has been reported in the past to be a rare side effect of immune control inhibitor (ICI) drugs used for the treatment of non-small cell lung cancer, and several cases have been reported. A 78-year-old patient who underwent a left pneumonectomy after being diagnosed with NSCLC one year earlier had a history of esophageal stenting and Nivolumab use two months previously to relieve the pressure of a mediastinum mass invading the esophagus that was causing dysphagia in the patient. The patient developed TEF in the first week of hospitalization, which was thought to be a side effect of the ICI drugs. Our case, who was thought to place a stent in the trachea, died after developing massive hemoptysis. We present this case of the development of TEF to literature due to its rarity as a side effect of ICI drugs.

Keywords: Tracheoesophageal fistula, lung cancer, immunotherapy

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Nivolumab Ýliþkili Trakeaözefagial Fistül

Ayþe Bahadýr, Sibel Yurt, Mehmet Akif Özgül, Muhammet Atýf Karagöl, Levent Arafat
Çam ve Sakura Þehir Hastanesi, Ýstanbul

Trakea ve özafagus arasýnda patolojik bir baðlantý olmasý trakea-özafagiyal fistül (TÖF) olarak adlandýrýlýr, doðuþtan veya bening ya da maling nedenlere baðlý sonradan oluþabilmektedir. TÖF, akciðer ve özefagus kanserlerinde kemoradyoterapi sonrasý veya mediastinal invazyon nedeni ile geliþen, yüksek morbidite ve mortaliteye neden olan bir komplikasyondur. Son yýllarda Non-small cell akciðer kanseri (NSCLC) tedavisinde immun kontrol inhibitör (ICI) ilaçlarýn kullanýmýnýn artýþýna baðlý nadir görülen yan etkiler ortaya çýkmakta ve olgu bazýnda bildirilmektedir. Yetmiþ sekiz yaþýnda bir yýl önce NSCLC tansý ile sol pnömonektomi olan olgumuzda mediastene invaze kitlenin özafagusa basýsýna baðlý disfaji nedeni ile iki ay önce özafagusa stent uygulama ve nivolumab kullaným öyküsü vardý. Yatýþýnýn ilk haftasýnda hastada TÖF geliþti. Trakeaya stent yerleþtirilmesi düþünülen olgumuz, masif hemoptizi geliþmesi nedeni ile eksitus oldu. Ayýrýcý taný sonrasý ICI ilaça baðlý yan etki olarak TÖF geliþtiði düþünüldü. Nadir bir yan etki olarak görülmesi nedeni ile olgumuzu literatür bilgileri ile sunmak istedik.

Anahtar Kelimeler: Trakeaözefagial fistül, akciðer kanseri, immunoterapi

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