Cryospray ablation (CSA) in the palliative treatment of squamous cell carcinoma of the esophagus

Brooks D Cash, Lavonne R Johnston, Mark H Johnston, Brooks D Cash, Lavonne R Johnston, Mark H Johnston

Abstract

Background: Esophageal carcinoma is the ninth most prevalent cancer worldwide with squamous cell carcinoma (SCCA) and adenocarcinoma accounting for the vast majority of new cases (13,900 in 2003). Cure rates in the U.S. are less than 10%, similar to lung cancer. More than 50% of patients with esophageal carcinoma present with unresectable or metastatic disease, are not surgical candidates, or display disease progression despite the addition of neoadjuvant chemoradiotherapy to surgery. Need for improved palliation exits.

Case presentation: This case describes a 73-year-old African American male who presented with recurrent squamous cell carcinoma (SCCA) of the esophagus who has a achieved complete remission for 24 months via endoscopic cryospray ablation.

Conclusion: Endoscopic cryo spray ablation warrants further investigation as a palliative treatment modality for esophageal cancer. This is the first reported case in the medical literature.

Figures

Figure 1
Figure 1
Squamous cell carcinoma (SCCA) in the proximal esophagus at 24 cm from the incisors. This lesion occurred above the prior radiation therapy treatment field.
Figure 2
Figure 2
Histology of figure 1. This is a moderately differentiated SCCA (H&E).
Figure 3
Figure 3
Cryospray ablation (CSA) of the SCCA in figure 1. On the left is the cryo decompression tube. In the right fore corner is the cryo catheter.
Figure 4
Figure 4
Endoscopic appearance of the SCCA (figure 1) one month after cryospray ablation.
Figure 5
Figure 5
Fibrotic stricture which developed after the second cryospray ablation treatment.

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