Malignant Broncho-Oesophageal Fistula following Radiotherapy for Noninvasive T3 Oesophageal Squamous Cell Carcinoma

Malignant tracheo-oesophageal fistula (TEF) can result from tumour progression and invasion of adjacent organs, or a complication of treatment. In the posttreatment setting, incidence of TEF in cases with preceding airway invasion (T4b) are not infrequently reported; however, for those for whom disease was confined to organ (T1–3) at staging, this is a rare complication. Management for these cases is palliative in nature, with the goal to prevent aspiration by closing the connection and facilitate safe resumption of oral intake where possible. Herein we report a case of a 71-year-old female with a T3 oesophageal squamous cell carcinoma, who presented with new onset dysphagia 2 weeks after completing a course of definitive radiotherapy and was found to have a broncho-oesophageal fistula. This patient was managed with dual stenting of both the airway and oesophagus, an emerging management option for this condition, and was thereafter able to safely resume oral intake.