Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5810
Peer-review started: December 1, 2021
First decision: January 12, 2022
Revised: January 13, 2022
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: June 16, 2022
Processing time: 190 Days and 6.5 Hours
Wernicke encephalopathy is a rare but potentially fatal adverse event caused by thiamine deficiency. Reports of non-alcoholic Wernicke encephalopathy due to malignancy are scarce in the literature, with those reported mainly being on haematological cancer, followed by gastrointestinal cancer. As a result, there is considerable under-recognition and delay in the diagnosis and treatment of Wernicke encephalopathy in oncology departments. To our knowledge, there has been no report of Wernicke encephalopathy in a patient with esophageal cancer while receiving radiotherapy.
A 64-year-old man presented to the oncology outpatient clinic with a history of dysphagia for 2 mo, and was diagnosed with locally advanced esophageal squamous cell carcinoma (stage IIIB). Radiotherapy was initiated to alleviate dysphagia due to malignant esophageal stenosis; however, the patient exhibited consciousness disturbances starting on day 10 of radiotherapy. Brain magnetic resonance imaging indicated the development of Wernicke encephalopathy. Subsequent treatment with thiamine led to rapid improvement in the patient’s neurological symptoms.
Wernicke encephalopathy may develop in non-alcoholic patients undergoing radiotherapy for esophageal cancer. Early diagnosis and sufficient thiamine supplementation during radiotherapy are essential.
Core Tip: Wernicke encephalopathy is a neuropsychiatric disorder resulting from thiamine deficiency. It is frequently associated with alcoholism and is challenging to diagnose in non-alcoholic patients. Only scarce reports of Wernicke encephalopathy accompanying cancer have been reported, mainly in haematological malignancies followed by gastrointestinal malignancies. There have been no reports about Wernicke encephalopathy accompanying esophageal cancer. Here we report the first case of Wernicke encephalopathy in an esophageal cancer patient receiving radiotherapy. It is presented to emphasize that early nutritional evaluation and diagnosis are important. Prompt thiamine supplementation is the key to preventing permanent neurological damage.