Mediastinal Lymph Node Metastasis and Immune-related Adverse Reactions after Cyberknife Surgery for Advanced Esophageal Cancer:A Case Report and Literature Review
Esophageal cancer is a highly prevalent malignant tumor in China,characterized by limited lymph node dissection and occult micrometastasis,which often result in post-surgical recurrence and metastasis.This article presents the diagnosis and treatment of a patient with genitourinary symptoms following Cyberknife treatment and long-term immunotherapy for advanced esophageal cancer with mediastinal lymph node metastasis.The patient had previously undergone TOMO and IMRT for mediastinal lymph-node metastases.After evaluating the recurrence and progressive enlargement of the lymph nodes,re-treatment was performed using Cyberknife radiotherapy.Subsequently,long-term immunotherapy led to a significant increase in white blood cells on urine routine analysis,while urine culture and cytology were negative.Immune adverse reactions in the urinary system are rarely reported,lacking clear diagnostic criteria.Following multidisciplinary consultation(MDT)and literature review,immune cystitis was diagnosed in this patient.This article reviews cases of mediastinal lymph node metastasis in esophageal cancer to elucidate its clinical characteristics,particularly highlighting the safe and effective role of Cyberknife as a treatment modality for esophageal cancer with mediastinal lymph node metastasis.Additionally,it provides valuable insi-ghts into early diagnosis and management of immune cystitis.
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