Fatal Tracheoesophageal Puncture Leakage Associated With Lenvatinib.

Fatal tracheoesophageal puncture leakage associated with Lenvatinib treatment was reported by Salvatori S. and Tanvetyanon  T.  from Moffitt Cancer Center and Research Institute, Tampa, FL. The report was published in Cureus [15(8): e43490]. 

Tracheoesophageal puncture (TEP) is a voice restorative is often used in laryngectomees. Though generally safe, TEP may develop leakage. Lenvatinib is a tyrosine kinase inhibitor (TKI) with anti-tumoral activity against head and neck malignancies. TKIs, including lenvatinib, have been associated with organ perforation or fistula formation. The authors described a patient with adenoid cystic carcinoma of the larynx who had a TEP for several years. After approximately two weeks of treatment with lenvatinib, the patient developed a leakage of TEP. Despite several interventions, the patient died three months afterward due to a retropharyngeal abscess secondary to Fusobacterium nucleatum infection.

To the authors’ knowledge, this is the first report of fatal lenvatinib-associated TEP leakage. They urge clinicians to be cognizant of the potentially rapid development of this complication when prescribing TKI for patients with TEP.

 

Leakage through voice prosthesis barrel (central leakage):