Radyoterapiye Bagli Gelisen Akalazya Benzeri Ozofagiyal Motor Bozukluk

Mustafa Cengiz

doi:10.12996/gmj.2014.33

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.

Highlights

Achalasia is characterized as a failure of relaxation of the lower esophageal sphincter and reduced motor activity in the body of the esophagus, manometrically
Spastic contractions in the esophageal body, the disease is referred to as vigorous achalasia which was more recently named as spastic achalasia (1)
We report a case to demonstrate an achalasia-like motor disorder of esophageal motility caused by 60 Gy radiation therapy to the neck for tongue base carcinoma

Summary

INTRODUCTION

Achalasia is characterized as a failure of relaxation of the lower esophageal sphincter and reduced motor activity in the body of the esophagus, manometrically. Radiation exposure can denervate ganglionic cells of myenteric plexus and cause achalasia like syndrome (3) In this context, we report a case to demonstrate an achalasia-like motor disorder of esophageal motility caused by 60 Gy radiation therapy to the neck for tongue base carcinoma. We report a case to demonstrate an achalasia-like motor disorder of esophageal motility caused by 60 Gy radiation therapy to the neck for tongue base carcinoma This presentation is extremely rare and unusual. One month after the end of the chemoradiation the patient was referred to the department of gastroenterology with the painful deglutition disorder for both liquid and solid foods, and subsequently his condition became more severe by the onset time. He had no complaint and had a routine endoscopic examination with normal findings before the radiation therapy

DISCUSSION

Findings

CONCLUSION