Proximal Esophageal Squamous Cell Carcinoma Following Hodgkin’s Lymphoma: Chronic Dysplasia and Esophageal Strictures

27 Nov 2024 16:00 17:30
Houston, Texas
Mehnaz Shafi Host

Patient Profile & Clinical History

  • Patient: 40-year-old woman

  • Medical History: Hodgkin’s lymphoma, complicated by graft-versus-host disease (GVHD) of the esophagus.

  • Radiotherapy: Previously received XRT to the esophagus.

  • Subsequent Diagnosis: Developed squamous cell carcinoma (SCCA) of the esophagus.

Initial Diagnosis & Treatment

  • Stage: Stage II (uT3 N0 M0).

  • Treatment Decision: Nonsurgical therapy was selected.

  • Chemoradiotherapy: Weekly concurrent chemo-radiotherapy with weekly carboplatin AUC 2 and paclitaxel.

Response & Subsequent Course

  • Response to Treatment: Response to treatment was achieved.

  • Chronic Dysplasia: Chronic dysplasia persisted.

  • Esophageal Stenosis: Chronic intrinsic esophageal stenosis developed.

  • Endoscopic Management: Treated with repeated dilations and RFA to ablate the squamous dysplasia that persisted/recurred after completion of chemotherapy.

Clinical Summary

Both cases highlight proximal esophageal SCCA, systemic treatment, subsequent dysplasia and chronic strictures, treated with endoscopic therapy.

Multi-disciplinary Panel (MDACC)

Mehnaz A. Shafi (USA) | Wayne Hofstetter (USA) | Sun Mi Lee (USA) | George Triadafilopoulos (USA)

Topics for Discussion

  1. Management of chronic squamous cell dysplasia and early esophageal cancer

  2. Clinical assessment

  3. Means of treatment and durability: Endoscopic therapy, RFA, cryotherapy, surgery.

  4. Long-term follow-up: Management of chronic strictures.

  5. Review of literature: Pathology and endoscopic treatments.