Lemierre's Syndrome After Head and Neck Photoimmunotherapy for Local Recurrence of Nasopharyngeal Carcinoma

Overview

Journal Case Rep Oncol

Publisher Karger

Specialty Oncology

Date 2024 Feb 2

PMID 38304554

Authors

Midori Nishimura

Isaku Okamoto

Tatsuya Ito

Kunihiko Tokashiki

Kiyoaki Tsukahara

Affiliations

Soon will be listed here.

Abstract

Introduction: Head and neck photoimmunotherapy (HN-PIT) uses a combination of drugs and laser illumination to specifically destroy tumor cells. Lemierre's syndrome is an infectious disease with severe systemic symptoms caused by prior infection in the pharyngeal region, leading to thrombophlebitis. Here, we report a case of Lemierre's syndrome that developed after HN-PIT for recurrent nasopharyngeal carcinoma.

Case Presentation: A 68-year-old male with nasopharyngeal carcinoma (squamous cell carcinoma) underwent HN-PIT after local recurrence with chemoradiation therapy. Three months after HN-PIT, the patient developed fever and neck pain, which led to a diagnosis of Lemierre's syndrome. The patient was treated with antibiotics and anticoagulants for at least 1 month. The patient's general condition and inflammatory findings on blood sampling showed gradual improvement, and a follow-up cervicothoracic computed tomography imaging showed that the venous thrombus had been obscured and the patient was doing well.

Conclusion: HN-PIT is a high-risk procedure for the development of Lemierre's syndrome due to irradiation-induced mucositis, and anticipating the development of Lemierre's syndrome during HN-PIT is important.

Citing Articles

Near Infrared Photoimmunotherapy for Locoregionally Recurrent Oropharyngeal Squamous Cell Carcinoma at Tongue Base After Chemoradiotherapy: A Case Report and Literature Review.

Tamagawa S, Okuda K, Nishikawa D, Kono M, Hotomi M Cureus. 2024; 16(11):e74742.

PMID: 39735016 PMC: 11682689. DOI: 10.7759/cureus.74742.

References

Gando S, Iba T, Eguchi Y, Ohtomo Y, Okamoto K, Koseki K . A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: comparing current criteria. Crit Care Med. 2006; 34(3):625-31. DOI: 10.1097/01.ccm.0000202209.42491.38. View

Okamoto I, Okada T, Tokashiki K, Tsukahara K . A Case Treated With Photoimmunotherapy Under a Navigation System for Recurrent Lesions of the Lateral Pterygoid Muscle. In Vivo. 2022; 36(2):1035-1040. PMC: 8931901. DOI: 10.21873/invivo.12799. View

Johannesen K, Bodtger U . Lemierre's syndrome: current perspectives on diagnosis and management. Infect Drug Resist. 2016; 9:221-227. PMC: 5028102. DOI: 10.2147/IDR.S95050. View

Mitsunaga M, Ogawa M, Kosaka N, Rosenblum L, Choyke P, Kobayashi H . Cancer cell-selective in vivo near infrared photoimmunotherapy targeting specific membrane molecules. Nat Med. 2011; 17(12):1685-91. PMC: 3233641. DOI: 10.1038/nm.2554. View

Bone R, Balk R, Cerra F, Dellinger R, Fein A, Knaus W . Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992; 101(6):1644-55. DOI: 10.1378/chest.101.6.1644. View

Hahn J, Nordmann-Kleiner M, Hoffmann T, Greve J . Thrombosis of the internal jugular vein in the ENT-department - Prevalence, causes and therapy: A retrospective analysis. Auris Nasus Larynx. 2018; 46(4):624-629. DOI: 10.1016/j.anl.2018.11.009. View

Okamoto I, Okada T, Tokashiki K, Tsukahara K . Quality-of-Life Evaluation of Patients with Unresectable Locally Advanced or Locally Recurrent Head and Neck Carcinoma Treated with Head and Neck Photoimmunotherapy. Cancers (Basel). 2022; 14(18). PMC: 9496661. DOI: 10.3390/cancers14184413. View

Sinave C, Hardy G, Fardy P . The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine (Baltimore). 1989; 68(2):85-94. View

Omura G, Honma Y, Matsumoto Y, Shinozaki T, Itoyama M, Eguchi K . Transnasal photoimmunotherapy with cetuximab sarotalocan sodium: Outcomes on the local recurrence of nasopharyngeal squamous cell carcinoma. Auris Nasus Larynx. 2022; 50(4):641-645. DOI: 10.1016/j.anl.2022.06.004. View

10.

Okamoto I, Okada T, Tokashiki K, Tsukahara K . Photoimmunotherapy for Managing Recurrent Laryngeal Cancer Cervical Lesions: A Case Report. Case Rep Oncol. 2022; 15(1):34-39. PMC: 8832182. DOI: 10.1159/000521435. View

11.

Nishikawa D, Suzuki H, Beppu S, Terada H, Sawabe M, Hanai N . Near-Infrared Photoimmunotherapy for Oropharyngeal Cancer. Cancers (Basel). 2022; 14(22). PMC: 9688155. DOI: 10.3390/cancers14225662. View

12.

Tahara M, Okano S, Enokida T, Ueda Y, Fujisawa T, Shinozaki T . A phase I, single-center, open-label study of RM-1929 photoimmunotherapy in Japanese patients with recurrent head and neck squamous cell carcinoma. Int J Clin Oncol. 2021; 26(10):1812-1821. PMC: 8449763. DOI: 10.1007/s10147-021-01960-6. View