Double tracheal stents reduce side effects of progression of malignant tracheoesophageal fistula treated with immunotherapy: A case report

BACKGROUND: The protective effect of tracheal stents is reported to relieve airway obstruction and reduce side effects of rapid progression of malignant tracheoesophageal fistula (MTEF) after immunotherapy in this case with 10 mo follow-up. CASE SUMMARY: Two kinds of silicone stents were placed in the main airway of a 58-year-old male to relieve the airway obstruction caused by advanced esophageal carcinoma. The patient then received four doses of toripalimab. Subsequently, rapid, progressive deterioration of the original fistula was found. Although the fistula enlarged rapidly after immunotherapy, it remained covered completely, and likely because of this, his condition remained stable. Therefore, immunotherapy could be continued to treat the primary tumor. Despite these efforts, the patient died of the advancement of his esophageal cancer. CONCLUSION: Appropriately-sized tracheal stent placement combined with immune checkpoint inhibitors may improve the quality of life and survival of patients with MTEF.