Squamous Cell Carcinoma of the Esophagus in an Adolescent: A Case Report

Esophageal cancer is more common with increasing age and rarely seen below the age of 45. The current case report is a case of squamous cell carcinoma of the esophagus in a 17-year-old male patient who presented with progressive dysphagia and significant weight loss. Contrast-enhanced computed tomography (CECT) neck, chest, and abdomen showed a lesion involving the middle and lower third of the esophagus with contiguous involvement of the gastroesophageal junction (GEJ), extending from D7 to D11 vertebral segments and completely occluding the lumen. He was managed with chemoradiation, in which three cycles of chemotherapy (Carboplatin 220 mg and Paclitaxel 80 mg) were given, followed by 18 fractions of 40Gy radiotherapy. After this period of chemoradiation, he developed weakness and breathlessness; he was not able to ambulate and became completely bedridden. He underwent a feeding jejunostomy for nutrition, then neoadjuvant chemoradiotherapy (NACRT) and oncological resection with thoracoscopy-assisted transhiatal esophagectomy. The patient had bubbles in the intercostal tube drain while doing incentive spirometry and basal crepitations, so on the next day, a gastric Conray was done, which showed a suspected contrast leak into bilateral lung fields. CECT neck, chest, and abdomen confirmed the minor leak and was managed conservatively. The abdominal wound developed erythema on the seventh day and was opened showing a small amount of sanguinopurulent discharge, for which daily dressing was done along with antibiotic cefuroxime. On the seventh and eighth days, the patient experienced hoarseness in their voice, a condition managed with supportive care. The patient was successfully discharged after completing all management protocols. The report clearly highlights the need to suspect malignancy in young adults presenting with dysphagia.