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Rare presentation of subglottic soft-tissue swelling following FOLFOX therapy in a patient with metastatic oesophageal cancer
  1. Siva Naga S Yarrarapu1,
  2. Austin B Govero2,
  3. Faeq R Kukhon1 and
  4. Devang K Sanghavi1
  1. 1Critical Care Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA
  2. 2Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA
  1. Correspondence to Dr Devang K Sanghavi; Sanghavi.Devang{at}


Oesophageal cancer is categorised among the most fatal cancers across the world with a mortality ranking of sixth position. Chemotherapy with FOLFOX—a regimen of fluorouracil, leucovorin, and oxaliplatin—has been approved in the treatment of oesophageal cancer owing to its lower toxicity compared with the previous regimens. We report the first case of a patient with oesophageal cancer metastatic to the hyoid presenting with sudden-onset shortness of breath and anterior neck swelling secondary to treatment with FOLFOX-6. CT was notable for subglottic soft-tissue swelling and cystic necrosis of the hyoid bone tumour, and the patient subsequently required placement of a definitive airway via tracheostomy. This case illustrates the importance of anticipating the need for pre-emptive tracheostomy in patients with hyoid bone tumours receiving treatment with FOLFOX.

  • intensive care
  • oncology
  • chemotherapy
  • adult intensive care
  • oesophageal cancer

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  • Contributors SNSY drafted the case report, with regards to the title, summary, background and discussion, and took the pictures after consenting the patient. ABG participated in drafting the case report, with regards to the case presentation, differential diagnosis, treatment, outcome, and learning points. FRK reviewed and edited the case report. He reviewed the CT scan and selected the best images for submission. DKS has initiated the idea of writing a case report for this patient. He has reviewed and finalised the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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