No abstract

Cerebral abscess formation is a serious and life-threatening clinical entity, secondary to contiguous spread, hematogenous dissemination or direct inoculation. We present the case of a 61-year-old woman with a recent diagnosis of a locally advanced squamous cell carcinoma of the esophagus who was diagnosed with a brainstem abscess. In literature we only found three cases reporting cerebral abscess formation in patients with esophageal carcinoma. Our case report is considered exceptional given the abscess localization in the pons. The abscess was successfully treated with stereotactic drainage and antibiotics. This report emphasizes the importance of gastrointestinal tract evaluation in patients with diagnosis of cerebral abscess when no other cause is found. Brain abscesses must be recognized as a potentially fatal complication of esophageal carcinoma.

A 50-year-old woman presented with pain in her right upper abdomen. In her medical history we note a Caesarean section and a laparotomy with bilateral ovariectomy because of benign cysts. The liver enzymes were mildly elevated: aspartate transaminase 40 U/l (reference < 32 U/l), alanine transaminase 53 U/l (reference < 31 U/l), gamma-glutamyl transferase 97 U/l (reference 5 – 36). Computed tomography (CT) revealed a large lesion in the right liver lobe with a cyst within cyst appearance and with important compression of the surrounding tissue (figure 1, panel A). The total diameter measured 29 cm by 17 cm by 22 cm.