Tracheoesophageal fistula caused by chemotherapy in primary thyroid lymphoma: a case report

Primary thyroid lymphoma (PTL) is a rare malignant tumor of the thyroid, the diagnosis, and treatment of which are still controversial. Although the treatment of thyroid lymphoma causing respiratory obstruction is controversial, chemotherapy is considered the most effective treatment. Tracheoesophageal fistula is an extremely rare complication of chemotherapy. Here, we report a case of respiratory obstruction caused by a thyroid tumor. A 66-year-old female patient visited the hospital with a goiter with dyspnea. The patient was diagnosed with diffuse large B-cell lymphoma of the thyroid by core needle biopsy. After chemotherapy with a cyclophosphamide vincristine prednisone (CVP) regimen, the tumor obviously subsided, but the patient began to experience clinical symptoms such as hoarseness and difficulty drinking. Fiberoptic bronchoscopy and neck computed tomography revealed a tracheoesophageal fistula. The phenomenon of tracheoesophageal fistula resulting from chemotherapy for thyroid lymphoma is extremely rare. Standard treatment for thyroid lymphoma that causes respiratory tract obstruction does not exist. Through clinical case sharing, increase awareness and early recognition are particularly important in order to minimize appropriately the effect of the event and through this case report, so as to provide some suggestions for clinicians. Cases of airway obstruction should be fully evaluated before treatment, and temporary airway protection measures, such as tracheotomy, surgical decompression, and tracheal metal.