Case of radiation-induced esophageal ulcer worsened after endoscopic biopsy

Abstract

Esophageal ulcer is one of the most important late complications of the esophagus treated with radiation therapy, especially with intraluminal brachytherapy. We encountered a patient with esophageal cancer treated with external radiation therapy and intraluminal brachytherapy, who developed radiation ulcer and who had severe dysphagia soon after endoscopic biopsy of the ulcer edge. A 55-year-old man was diagnosed as esophageal cancer without symptoms. He received 60 Gy/30 Fr of external radiation therapy and 12 Gy/3 Fr of intraluminal brachytherapy at a point of 5 mm in depth from the mucosa surface. He developed an asymptomatic esophageal ulcer 13 months after treatment, and endoscopic biopsy was obtained from the edge of the ulcer. Thereafter, swallowing difficulties appeared, and endoscopy revealed severe esophageal stenosis and a deep ulcer. A possibility that the biopsy contributed to worsening the ulcer can be considered. Except for cases where relapse is apparent, endoscopic biopsy is considered to be avoided.

Cell sheet engineering: a unique nanotechnology for scaffold‐free tissue reconstruction with clinical applications in regenerative medicine

“…Cell sheet technology for the treatment of oesophageal ulceration Oesophageal ulcerations are a major postoperative inflammation and stenosis that can affect the patient’s quality of life [66]. For the treatment of oesophageal ulcerations, we have developed a method combining endoscopic submucosal dissection with the endoscopic transplantation of autologous oral mucosal epithelial cell sheets [44].…”