Transhiatal esophagectomy for distal esophageal cancer during pregnancy: A rare and challenging case report

Introduction: Esophageal cancer during pregnancy is extremely very rare. The diagnosis of esophageal cancer during pregnancy is not easy because of overlapping clinical presentation of the disease and pregnancy related symptoms. The management of esophageal cancer during pregnancy is also very challenging. This is because of the absence of standard treatment guidelines and all treatment options have significant risk both on the mother and fetus. Case presentation: We present a 35 years old multipara women presented with difficulty of swallowing solid meal initially and later both to solid and liquid diet of 3 months duration and significant weight loss of same duration at gestational age of 27 weeks whom successfully treated with trans hiatal esophagectomy and discharged from the hospital uneventfully. Discussion: Proper patient evaluation and high index of suspicion is very important in order to detect esophageal at its early stage. Multidisciplinary and individualized patient approach should be advised to manage esophageal cancer during pregnancy as there is no standard treatment guideline. For resectable esophageal cancer during pregnancy, esophagectomy can be a treatment option as free margin tumor resection with lymph node clearance is the only curative treatment option for esophageal cancer. Conclusion: Esophagectomy can be one of the option of treatment for pregnant women diagnosed with resectable esophageal cancer without causing major risk both on the patient and pregnancy.