65 Localised cavity formation in oesophageal carcinoma

Background Oesophageal cavity formation secondary to oesophageal carcinoma is a rare complication, with significant morbidity and mortality. We describe two cases treated with a partially covered Cook stent for symptom control and palliation. Aim To describe the management of oesophageal cavity formation secondary to oesophageal carcinoma. Method Retrospective case notes review. Results Case 1-A 67 year old gentleman presented with dysphagia. OGD showed a squamous cell carcinoma in the lower oesophagus with imaging showing no metastatic disease. Four weeks after diagnosis he deteriorated rapidly with pyrexia and malaise. Repeat OGD showed a large cavity with mediastinal structures seen. A 12 cm partialy covered Cook stent was deployed. Subsequent CT Chest revealed no distal leak/fistula, and he was discharged after 5 days with nutritional optimisation. He was palliated in the community and died almost 4 months after his stent insertion. Case 2-A 84 year old gentleman with known metastatic oesophageal adenocarcinoma who had undergone palliative chemo/radiotherapy presented with regurgitation of food. OGD showed a cavity with mediastinal structures seen. A 12 cm partially covered Cook stent was deployed. Subsequent CT Chest revealed a small cavity with no distal leak/fistula, and was discharged after 4 days. He was palliated in the community, and died 13 months after his procedure. Conclusions Oesophageal cavity formation is a rare complication of oesophageal carcinoma. Management options include surgical and none surgical conservation options. We describe successful none operative management via partially covered stent insertion, facilitating palliation and reducing morbidity with significant improvement in quality of life.