食道癌治療後併發主動脈弓假性動脈瘤－病例報告

Aortic Arch Pseudoaneurysm after Esophageal Cancer Treatment: A Case Report

陳沛廷(Pei-Ting Chen) ； 巫宏博(Hung-Bo Wu) ； 呂敏吉(Ming-Chi Lu) ； 周益聖(Yi-Sheng Chou) ； 簡旭敏(Hsu-Min Chien)

《北市醫學雜誌》 15卷4期 (2018/12) Pp. 74-81

https://doi.org/10.6200/TCMJ.201812_15(4).0009

摘要

一位58歲女性，因食道癌四期合併肺炎入院，其曾於14個月前在他院接受過同步化放療，入院後電腦斷層發現主動脈弓假性動脈瘤。此種病症臨床上雖然罕見，但是往往造成致命的危險，經各專科同仁與病人及家屬多次討論溝通之後，病人最後決定接受胸主動脈覆膜支架手術，手術後症狀顯著緩解。吾人欲藉由此病例，討論有關食道癌治療後，此種罕見病症之臨床診斷與處理。

關鍵字

食道癌 ； 主動脈假性動脈瘤

並列摘要

A 58-year-old female with a history of stage IV esophageal cancer was hospitalized under the diagnosis of pneumonia. She received a concurrent chemoradiotherapy (CCRT) for esophageal cancer 14 months before. During this hospitalization period, an aortic arch pseudoaneurysm was discovered on the computerized tomography scan. The pathogenesis of pseudoaneurysm may be caused by the weakness of arteriosclerotic vessel walls and structural anomaly. It is rare but often a fatal condition post CCRT. We consulted the specialists and discussed the risks and benefits of surgical intervention with the patient and her family. They decided to receive a thoracic aortic aneurysm (TAA) stent-graft and her symptoms subsided after surgery. We herein report and discuss the clinical diagnosis and management of this rate case.

並列關鍵字

Esophageal cancer ； Aortic pseudoaneurysm