• Shuang Zhao, Ni Sun, Xi Yuan, Zetian Shen, Xixu Zhu, and Jing Li.
• Department of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Jiangsu, China.
• Medicine (Baltimore). 2021 Mar 5; 100 (9): e24462e24462.

IntroductionNumerous investigations have been performed to explore candidate biomarker proteins in esophageal squamous cell carcinoma (ESCC) patients, which could predict the response to chemoradiotherapy (CRT). Here we report a patient with unresectable ESCC who had unsatisfactory effects with radiotherapy, chemotherapy and immunotherapy. We performed genetic analysis in this patient to gain insights about the cause of the rapid progression.Patient ConcernsA 65-year-old man presented with food obstruction, hoarse voice and choking on drinking water for 2 months, and pain behind the breastbone for 1 month.DiagnosisThe patient was clinically diagnosed with ESCC and staged as T4N1M1 Stage IV.InterventionsThe patient was treated with CRT and immunotherapy. Mutational analyses through high throughput DNA sequencing methodology (next generation sequencing; NGS) was performed on the patient's blood sample.OutcomesThe tumor progressed rapidly during the treatment period, and the patient passed away only 3 months from the onset of symptoms.ConclusionAlthough the role of TP53 gene and PIK3CA gene in the progression, treatment and sensitivity of esophageal cancer has been studied, the mechanism of their simultaneous appearance has not been demonstrated in relevant studies. We speculate that the reason for the rapid progression in this patient during active treatment might be related to this. Further studies are needed to validate our observations.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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