• Kyung Eun Shin.
• Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea.
• Medicine (Baltimore). 2022 May 27; 101 (21): e29426e29426.

RationaleEsophageal cancer is one of the leading causes of death worldwide; the treatments vary according to the stage at diagnosis. Advanced esophageal cancer is usually treated by concurrent chemoradiation which is associated with complications including esophagitis, esophageal stricture or perforation, radiation pneumonitis, and/or cardiac toxicity. Herein, we describe epidural abscess, which is a very rare but severe complication that can occur after concurrent chemoradiation therapy for advanced esophageal cancer.Patient ConcernsA 75-year-old man developed a fever during concurrent chemoradiation therapy for advanced esophageal cancer, which progressed to neurological deficit and paraplegia. Enhanced chest computed tomography and C-spine magnetic resonance imaging were performed.DiagnosisChest computed tomography revealed a poorly enhanced necrotic change in the cervical esophageal cancer, with mottled dirty material and fluid collection. C-spine magnetic resonance imaging revealed a prevertebral abscess with pyogenic spondylitis at the C6-T2 level. In addition, an anterior epidural abscess at the C6-7 level compressed the spinal cord.InterventionsThe patient underwent emergency anterior cervical discectomy and decompression corpectomy.Outcomes: After surgery, the neurological symptoms gradually improved.LessonsPyogenic spondylitis with an epidural abscess is a rare but life-threatening complication that can develop after concurrent chemoradiation therapy for advanced esophageal cancer. Rapid, accurate diagnosis and prompt surgical treatment are important to ensure a favorable long-term prognosis and a good quality of life.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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