Esophageal pseudodiverticulum following high-dose-rate intracavitary irradiation for esophageal cancer.

Ninety-two patients with esophageal carcinoma were treated with combination therapy of external irradiation and high-dose-rate intracavitary irradiation. Four of the 92 patients developed esophageal pseudodiverticulum after radiotherapy. Histologically, all four patients showed squamous cell carcinoma before radiotherapy and were locally controlled by the combination therapy. In three of the four cases, pseudodiverticulum was found over one year after radiotherapy. In two of these three cases, pseudodiverticulum correlated with balloon dilatation performed for benign stricture. The pseudodiverticulum of the other case was found at the end of radiotherapy and was thought to be a traction diverticulum. None of the four patients developed a fistula. As of this writing, one of them has been alive and well for 50 months since the initiation of radio-therapy. Two of the other three died due to metastasis 18 months and 27 months later. The last one died due to intercurrent disease 39 months later.