A Rare Case of Gastropleural Fistula During Chemotherapy for Metastatic Colorectal Cancer

Gastropleural fistula (GPF) is a rare and life-threatening condition, often associated with peptic ulcer disease, trauma, abscess, malignancies, prior surgeries, or chemoradiation therapy. Its rarity, diverse clinical presentations, and the general condition of affected patients make GPF challenging to diagnose and treat. We present a case of GPF occurring during chemotherapy with anti-vascular endothelial growth factor (anti-VEGF) therapy for stage IV colon cancer with multiple peritoneal metastases. The patient underwent surgical repair of the fistula four weeks after the last administration of anti-VEGF therapy. Postoperative recovery was uneventful, and the patient successfully resumed oral intake. To the best of our knowledge, this is the first reported case of GPF in the context of stage IV colon cancer. This case highlights the importance of selecting an appropriate timing for surgical intervention, taking into account the patient's overall condition and treatment history.