Esophageal-meningeal fistula after anterior cervical corpectomy, stereotactic body radiation therapy (SBRT), and bevacizumab-containing systemic therapy for metastatic epidural spinal cord compression (MESCC)

•We report a case of an esophageal-meningeal fistula following anterior cervical corpectomy, SBRT, and bevacizumab-containing systemic therapy for MESCC.•Fistula formation is an inherent individual risk of anterior cervical surgery, radiation, and bevacizumab use.•A high index of suspicion is necess...

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Bibliographic Details
Published in:	Interdisciplinary neurosurgery : Advanced techniques and case management Vol. 26; p. 101343
Main Authors:	Monk, Steve H., Biester, Eliane C., Kadakia, Kunal C., Healy, Andrew T., Heinzerling, John H.
Format:	Journal Article
Language:	English
Published:	Elsevier B.V 01-12-2021 Elsevier
Subjects:	Esophageal-meningeal fistula Metastatic epidural spinal cord compression Stereotactic body radiation therapy Metastatic epidural spinal cord compression Esophageal-meningeal fistula Stereotactic body radiation therapy
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Summary:	•We report a case of an esophageal-meningeal fistula following anterior cervical corpectomy, SBRT, and bevacizumab-containing systemic therapy for MESCC.•Fistula formation is an inherent individual risk of anterior cervical surgery, radiation, and bevacizumab use.•A high index of suspicion is necessary to identify such a rare and morbid complication in a timely fashion.•Fistula formation is an inherent individual risk of anterior cervical surgery, radiation, and bevacizumab use. Metastatic epidural spinal cord compression (MESCC) is a common complication of malignancy. Surgical decompression and stabilization are commonly undertaken to prevent mechanical instability and deformity, relieve neurologic compression, and facilitate stereotactic body radiation therapy (SBRT). We report a case of an esophageal-meningeal fistula following anterior cervical corpectomy, SBRT, and bevacizumab-containing systemic therapy for MESCC. Esophageal-meningeal fistulae have been rarely reported following injury to the esophagus and dura at the time of surgery or in a delayed manner secondary to hardware failure. Our report is the first to highlight that, in the absence of such injury, anterior decompression can still create the possibility of esophageal-meningeal fistula in the treatment field.
ISSN:	2214-7519 2214-7519
DOI:	10.1016/j.inat.2021.101343