AccScience Publishing / TD / Online First / DOI: 10.36922/TD025330083
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CASE REPORT

Advanced gastric and esophageal malignant tumor complicated by chylous ascites: A case report

Xiaochun Zhang1 ,  Jialing Shi2 ,  Guanwen Gong3*
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1 The Second Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
2 School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
3 Department of Colorectal Surgery, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
Tumor Discovery, 025330083 https://doi.org/10.36922/TD025330083
Received: 17 August 2025 | Revised: 31 August 2025 | Accepted: 8 September 2025 | Published online: 26 September 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Chylous ascites caused by lymphatic vessel obstruction due to compression from advanced gastric and esophageal malignant tumors is relatively rare in clinical practice. It is often accompanied by malnutrition, hypoproteinemia, and a poor prognosis. We report a patient with an advanced gastric and esophageal malignant tumor complicated by chylous ascites. Management focused on symptom control and individualized nutritional support, including intravenous medium-chain triglyceride emulsion together with enteral nutritional emulsion administered through a nasoenteric tube, paracentesis for symptomatic relief, and supportive measures. Although the underlying malignancy determined the overall prognosis, and the patient died in May 2023, the interventions provided temporary improvement in symptoms and nutritional status. This case highlights the importance of early recognition of chylous ascites and of prioritizing symptom relief, individualized nutritional strategies, and palliative goals of care in patients with advanced malignancy.

Keywords
Gastric cancer
Esophageal malignant tumors
Chylous ascites
Palliative treatment
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
References
  1. Lizaola B, Bonder A, Trivedi HD, Tapper EB, Cardenas A. Review article: The diagnostic approach and current management of chylous ascites. Aliment Pharmacol Ther. 2017;46(9):816-824. doi: 10.1111/apt.14284

 

  1. Patil AR, Nandikoor S, De Marco J, et al. Disorders of the lymphatic system of the abdomen. Clin Radiol. 2016;71(10):941-952. doi: 10.1016/j.crad.2016.06.116

 

  1. Bhardwaj R, Vaziri H, Gautam A et al. Chylous ascites: A review of pathogenesis, diagnosis and treatment. J Clin Transl Hepatol. 2018;6(1):105-113. doi: 10.14218/jcth.2017.00035

 

  1. Browse NL, Wilson NM, Russo F, Al-Hassan H, Allen DR. Aetiology and treatment of chylous ascites. Br J Surg. 1992;79(11):1145-1150. doi: 10.1002/bjs.1800791110

 

  1. Zhang SJ, Zhao WH, Yu LP et al. Minimal fat renalangiomyolipoma with multiple lymph nodes enlargement and postoperative refractory lymphatic fistula: A case report and literature review. Beijing Da Xue Xue Bao Yi Xue Ban. 2018;50(4):717-721. doi: 10.3969/j.issn.1671-167x.2018.04.025

 

  1. Meroni M, Scaglioni MF. The use of superficial circumflex iliac perforator (SCIP) pedicle vein for lymphovenous anastomosis to treat inguinal lymphatic fistula: A case report. Microsurgery. 2024;44(4):e31181. doi: 10.1002/micr.31181

 

  1. Nicol DL. Therapeutic lymphangiography for chylous ascites. BJU Int. 2022;129(5):559-560. doi: 10.1111/bju.15706

 

  1. Duletzke NT, Kiraly LN, Martindale RG. Chylothorax and chylous ascites: Overview, management, and nutrition. Nutr Clin Pract. 2023;38(3):557-563. doi: 10.1002/ncp.10973

 

  1. Youssef EW, Aly A, Brahmbhatt A, Moussa A, Santos E. Lymphatic interventions in the cancer patient. Curr Oncol Rep. 2022;24(10):1351-1361. doi: 10.1007/s11912-022-01293-1

 

  1. Pieper CC. Nodal and pedal MR lymphangiography of the central lymphatic system: Techniques and applications. Semin Intervent Radiol. 2020;37(3):250-262. doi: 10.1055/s-0040-1713442

 

  1. Yildirim AE, Altun R, Can S et al. Idiopathic chylous ascites treated with total parenteral nutrition and octreotide. A case report and review of the literature. Eur J Gastroenterol Hepatol. 2011;23(10):961-963. doi: 10.1097/meg.0b013e328349aa2d

 

  1. Tan X, Luo G, Liao G, Liao H. Postoperative chylous ascites in gynecological malignancies: Two case reports and a literature review. Obstet Gynecol Int. 2024;2024:1810634. doi: 10.1155/2024/1810634

 

  1. Weniger M, D‘Haese JG, Angele MK, et al. Treatment options for chylous ascites after major abdominal surgery: A systematic review. Am J Surg. 2016;211(1):206-213. doi: 10.1016/j.amjsurg.2015.04.012

 

  1. Santos E, Moussa AM. Chylous ascites and lymphoceles: Evaluation and interventions. Semin Intervent Radiol. 2020;37(3):274-284. doi: 10.1055/s-0040-1713445

 

  1. Iwazu Y, Komori S, Nagata D. Change of chylous ascites during low-density lipoprotein apheresis in a patient with idiopathic nephrotic syndrome. Ther Apher Dial. 2015;19(1):97-98. doi: 10.1111/1744-9987.12225

 

  1. Al-Busafi SA, Ghali P, Deschenes M, Wong P. Chylous ascites: Evaluation and management. ISRN Hepatol. 2014;2014:240473. doi: 10.1155/2014/240473

 

  1. Karakousi T, Mudianto T, Lund AW. Lymphatic vessels in the age of cancer immunotherapy. Nat Rev Cancer. 2024;24: 363-381. doi: 10.1038/s41568-024-00681-y
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Tumor Discovery, Electronic ISSN: 2810-9775 Print ISSN: 3060-8597, Published by AccScience Publishing
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