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Case Report
Rare case of recurrent chylothorax following irradiation for esophageal cancer
1 Department of Medical Oncology, University Hospital Limerick, Limerick, Ireland
2 Mid-Western Radiation Oncology Centre, Limerick, Ireland
3 Department of Respiratory Medicine, University Hospital Limerick, Ireland
4 Department of Thoracic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
Address correspondence to:
Ruba Ahmed Hamed
Midwest Cancer Center, Oncology Department, University Hospital Limerick,
Ireland
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Article ID: 100086Z10RH2021
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Hamed RA, Mahgoub T, Elbassiouni M, O’Brien A, Redmond KC, Korpanty G. Rare case of recurrent chylothorax following irradiation for esophageal cancer. J Case Rep Images Oncology 2021;7:100086Z10RH2021.ABSTRACT
Introduction: Chylothorax is a rare cause of pleural effusion that results from damage of the thoracic duct and chyle leakage from the lymphatic system into the pleural space. Causes of chylothorax can be traumatic or non-traumatic. Chylothorax occurring due to damage to the thoracic duct by thoracic irradiation is rare, and infrequently described in the literature.
Case Report: We present a case of a 74-year-old patient with a history of stage IV esophageal cancer who developed recurrent bilateral chylothoraces after palliative radiotherapy to her esophagus. She was treated conservatively with multiple modalities, including total parental nutrition leading to an oral low-fat medium-chain triglyceride diet, subcutaneous octreotide injection, and long-term insertions of bilateral chest drains.
Conclusion: This case report and discussion highlight that chylothorax is a rare complication of radiotherapy. A suspicion of chylothorax should be raised in patients who present with recurrent pleural effusions after radiotherapy to the esophagus or mediastinum, as early intervention can improve outcomes in these patients.
Keywords: Chylothorax, Esophageal cancer, Radiotherapy
SUPPORTING INFORMATION
Author Contributions
Ruba Ahmed Hamed - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Thamir Mahgoub - Revising it critically for important intellectual content, Final approval of the version to be published
Mazen Elbassiouni - Revising it critically for important intellectual content, Final approval of the version to be published
Aidan O'Brien - Revising it critically for important intellectual content, Final approval of the version to be published
Karen C Redmond - Revising it critically for important intellectual content, Final approval of the version to be published
Greg Korpanty - Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Ruba Ahmed Hamed et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
