内容紹介
A Case of Esophageal Cancer in a Patient with CMV Reactivation after Neoadjuvant Chemoradiation Therapy
Summary
A 68-year-old woman was diagnosed with advanced esophageal cancer with lymph node metastasis, for which she received neoadjuvant chemoradiotherapy. During therapy, she had loss of appetite and weight; therefore, we inserted a nasal feeding tube for her nutrition, after which, she gained weight soon. After therapy, she had a high fever with lymphocytopenia and was diagnosed with cytomegalovirus infection because of significantly high CMV antigenemia. Ganciclovir was administered immediately, and she recovered soon. Two months later, we performed esophagectomy, and she recovered without complications. Immediate diagnosis of CMV infection, ganciclovir administration, and nutrition through a feeding tube were useful for the esophageal cancer patient in this report who had immunosuppression and malnutrition during chemoradiation.
要旨
症例は68歳,女性。リンパ節転移を伴う進行食道癌の診断で術前化学放射線治療を施行。治療中に食欲低下および体重減少を認めたため経鼻経管栄養を開始し体重減少は速やかに改善した。治療終了後に,著明なリンパ球数低下を伴う発熱を来し,精査でサイトメガロウイルス感染と診断され,直ちにガンシクロビルの投与を開始し症状は改善した。2か月後,食道癌根治切除術を施行し軽快した。化学放射線治療後の低免疫,低栄養状態での発熱に対し迅速なサイトメガロウイルス感染診断,ガンシクロビル投与および経鼻経管栄養が有効であった。
目次
Summary
A 68-year-old woman was diagnosed with advanced esophageal cancer with lymph node metastasis, for which she received neoadjuvant chemoradiotherapy. During therapy, she had loss of appetite and weight; therefore, we inserted a nasal feeding tube for her nutrition, after which, she gained weight soon. After therapy, she had a high fever with lymphocytopenia and was diagnosed with cytomegalovirus infection because of significantly high CMV antigenemia. Ganciclovir was administered immediately, and she recovered soon. Two months later, we performed esophagectomy, and she recovered without complications. Immediate diagnosis of CMV infection, ganciclovir administration, and nutrition through a feeding tube were useful for the esophageal cancer patient in this report who had immunosuppression and malnutrition during chemoradiation.
要旨
症例は68歳,女性。リンパ節転移を伴う進行食道癌の診断で術前化学放射線治療を施行。治療中に食欲低下および体重減少を認めたため経鼻経管栄養を開始し体重減少は速やかに改善した。治療終了後に,著明なリンパ球数低下を伴う発熱を来し,精査でサイトメガロウイルス感染と診断され,直ちにガンシクロビルの投与を開始し症状は改善した。2か月後,食道癌根治切除術を施行し軽快した。化学放射線治療後の低免疫,低栄養状態での発熱に対し迅速なサイトメガロウイルス感染診断,ガンシクロビル投与および経鼻経管栄養が有効であった。