A case report of metastatic esophageal squamous cell carcinoma during pregnancy

Abstract

Esophageal cancer is extremely rare in pregnant women, accounting for only 0.07%–0.1% of all malignant neoplasms in pregnancy. It is rapidly progressive in nature and requires timely intervention. Our literature search yielded six case reports of esophageal cancers in pregnancy thus far. We herein report the case of a 30-year-old female, presenting at 32 weeks of gestation with complaints of hoarseness, dysphagia, and weight loss. The biopsy taken from within the esophagus, using an endoscope during an upper endoscopy procedure confirmed the diagnosis of squamous cell carcinoma of esophagus and Positron emission tomography-computed tomography revealed metastasis to parathyroid region. She was confirmed with metastatic squamous cell cancer positive for cytokeratin 5/6 and cytokeratin P40 immunohistochemistry. The Positron emission tomography-computed tomography of the chest showed a large hypermetabolic soft tissue mass in the mid-esophagus with significant proximal dilation. The head-and-neck computed tomography scan represented a necrotic nodal mass in the neck and circumferential mural thickening involving the mid-esophagus resulting in the proximal dilation confirming the primary tumor site. Two weeks after the delivery, the patient started a chemotherapy regimen consisting of nine cycles of Carboplatin and Paclitaxel. Postchemotherapeutic computed tomography showed remonstration of lesion in the thyroid gland and middle part of the esophagus. Thus, in pregnant patients with new onset hoarseness, dysphagia, or substantial weight loss, clinicians should keep esophageal cancer as part of their differentials. A thorough history, detailed physical examination, and imaging should be performed to determine esophageal cancer, as it can advance swiftly and has a poor prognosis if left untreated.