Self-expanding esophageal prosthesis. Effective palliation for inoperable carcinoma of the cervical esophagus

Whether to palliate dysphagia in patients with inoperable cancer of the cervical esophagus is a debatable issue. We report herein a patient who underwent definitive chemoradiotherapy for cancer of the cervical esophagus, with early recurrence of dysphagia 1 month after the end of the treatment. No salvage surgery was attempted due to the poor general conditions and to the residual effects of the radiotherapy in the neck. Endoscopically, the upper esophageal sphincter (UES) was located 17 cm from the incisors, and the cranial margin of an infiltrating stricture was just 1 cm below the sphincter. After endoscopic dilatation, a self-expanding esophageal prosthesis (Ultraflex, Microvasive, USA) was placed under endoscopic and radiologic control with the cranial margin at the level of the UES. The patient promptly resumed oral feeding and 2 months later he is still on unrestricted diet.