Odynophagia in patients with malignant disorders

Abstract

The differential diagnosis of odynophagia in patients with malignant disorders usually includes esophagitis due to herpes, Candida, or gastroesophageal reflux. Two cases and a review of the literature are presented that illustrate that leukemic infiltration of the esophagus and necrosis of the esophageal mucosa following chemotherapy should be considered in addition to the more commonly recognized causes. Esophagoscopy with biopsy and brushing for fungal stains is essential for the correct diagnosis since the various causes for odynophagia may be clinically and radiographically indistinguishable.

The management of treatment-related esophageal complications in children and adolescents with cancer

“…Vinblastine, dactinomycin, doxorubicin, 5-fluorouracil, and methotrexate have all been reported to cause esophageal ulcerations, fibrosis, and stricture formation [4,8,9]. In addition, doxorubicin and dactinomycin act as radiosensitizers and synergistically induce severe esophagitis and stricture formation when combined with radiotherapy [3,[10][11][12].…”

Esophagitis associated with multimodality management of pediatric Ewing sarcoma of thorax

“…showed significantly higher rates of acute esophagitis during and after radiotherapy with concurrent chemotherapy . Chemotherapeutic agents have been reported to cause direct mucosal injury like esophageal ulcerations and fibrosis, specifically vinblastine, dactinomycin, doxorubicin, 5‐fluorouracil, and methotrexate . In our study, nine of the 12 patients with esophagitis received a combination of IE shortly before developing symptoms.…”

Esophageal Strictures During Treatment for Acute Lymphoblastic Leukemia

“…Antineoplastic agents will affect the rapidly proliferating cells of the gastrointestinal tract and can lead to mucosal ulceration and necrosis. Chemotherapeutic agents reported to cause esophageal injury include methotrexate, 6 doxorubicin, 7 and cytarabine. 8 Repeated cycles of high dose dexamathasone are now a significant component of Medical Research Council UKALL 2003 protocol.…”