Radiotherapy Induced Achalasia-like Esophageal Motor Disorder

Authors

  • Mustafa Cengiz Ankara Oncology Education and Research Hospital
  • Şükran Ülger Gazi University Faculty of Medicine
  • İbrahim Doğan Gazi University Faculty of Medicine
  • Hüseyin Bora Gazi University Faculty of Medicine
  • Selahattin Ünal Gazi University Faculty of Medicine

Abstract

Achalasia is known as a neuromuscular disease caused by various reasons. A 59 year-old man was diagnosed with tongue base carcinoma. He underwent tumor excision and lymph node dissection. Due to the close surgical margin and muscle invasion, adjuvant chemoradiation was applied. Fifty Gray (Gy) radiation dose was prescribed to the neck lymph nodes and supraclavicular fossa; and 50 Gy radiation dose was applied to the surgical bed with an additional 10 Gy boost dose. One month after the end of the chemoradiation, the patient came with deglutition disorder. We performed an upper gastrointestinal endoscopy and high-resolution manometric study. High amplitude simultaneous pressure waves which were typical for vigorous achalasia were seen on esophageal manometry. Care should be taken about the possiblity of some rare esophageal motility disorders after the chemoradiation therapy especially in the early period.

Author Biographies

Mustafa Cengiz, Ankara Oncology Education and Research Hospital

Ankara Oncology Education and Research Hospital Department of Gastroenterology

Şükran Ülger, Gazi University Faculty of Medicine

Gazi University Faculty of Medicine Deparment of Radiation Oncology

İbrahim Doğan, Gazi University Faculty of Medicine

Gazi University Faculty of Medicine Department of Gastroenterology

Hüseyin Bora, Gazi University Faculty of Medicine

Gazi University Faculty of Medicine Department of Radiation Oncology

Selahattin Ünal, Gazi University Faculty of Medicine

Gazi University Faculty of Medicine Department of Gastroenterology

References

Pandolfino JE, Kwiatek MA, Nealis T et al. Achalasia: anew clinically relevant classification by high-resolution manometry. Gastroenterology 2008; 135: 1526-33.

Duntemann TJ, Dresner DM. Achalasia-like syndrome presenting after highly selective vagotomy. Dig Dis Sci 1995;40: 2081-3.

O'Rourke IC, Tiver K, Bull C et al. Swallowing performance after radiation therapy for carcinoma of the esophagus. Cancer 1988; 61: 2022-6.

Tucker HJ, Snape WJ, Jr., Cohen S. Achalasia secondary to carcinoma: manometric and clinical features. Ann Intern Med 1978; 89: 315-8.

Herskind C, Bamberg M, Rodemann HP. The role of cytokines in the development of normal-tissue reactions after radiotherapy. Strahlenther Onkol 1998; 174: 12-5.

Berthrong M, Fajardo LF. Radiation injury in surgical pathology. Part II. Alimentary tract. Am J Surg Pathol 1981; 5: 153-78.

Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys 1995; 3: 1213-36.

Emami B, Lyman J, Brown A, Coia L et al. Tolerance ofnormal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys Physics 1991; 21: 109-22.

Aggestrup S, Uddman R, Sundler F et al. Lack of vasoactive intestinal polypeptide nerves in esophageal achalasia. Gastroenterology 1983; 84: 924-7.

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Published

24.07.2014

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