Abstract

Undifferentiated carcinoma of the esophagus is a rare, aggressive tumor with no specific treatment guidelines and a poor prognosis. 5-Fluorouracil (5-FU), a key drug in the treatment of gastrointestinal cancer, is known for its rare but serious cardiotoxic effects. Here, we report a case of sudden cardiac death of a 47-yearold male with metastatic undifferentiated esophageal carcinoma following his second cycle of chemotherapy (FOLFOX). The patient developed chest pain and breathlessness after being discharged and was later declared dead on arrival at the hospital. Autopsy revealed myocardial infarction, and histopathology confirmed acute ischemic injury without an underlying coronary artery disease. Immunohistochemistry reaffirmed the undifferentiated carcinoma of the esophagus. This case highlights the fatal cardiotoxic effects of 5-FU, emphasizing the need for cardiac monitoring and considering alternate treatment protocols in high-risk individuals. It also underscores the importance of chemotherapy-induced cardiotoxicity as a differential diagnosis while doing postmortem evaluation of sudden deaths following cancer treatment.

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