Abstract
Endoscopic placement of self-expanding metal stents is regarded as a safe and effective
method of palliating obstructive esophageal malignancies. We report here the case
of a 49-year-old woman with an inoperable squamous-cell carcinoma located in the mid-esophagus.
After two courses of chemotherapy, a silicone-covered Gianturco-Z stent was placed
because of progressive tumor growth. Eighteen days after the stent placement, the
patient presented with hematemesis, and died 24 hours after admission. At autopsy,
the proximal end of the stent was found to have perforated through the normal esophageal
mucosa into the aorta, resulting in an aortoesophageal fistula. This complication
should be considered in patients who present with massive hemorrhage after undergoing
radiotherapy or chemotherapy, or both, before stent placement in the mid-esophagus.
