Case Report: A case of delayed-onset benign distal esophageal stricture after Yttrium-90 microsphere selective internal radiation therapy.

Yttrium-90 microsphere selective internal radiation therapy (Y90-SIRT) is a common local interventional treatment for hepatocellular Carcinoma and liver metastases. With the increasing use, extrahepatic complications have been gradually recognized. We report a case of a 47-year-old patient with hepatocellular carcinoma (HCC) who gradually developed distal esophageal ulcers and subsequent benign cicatricial stricture, clinically presumed to be radiation-induced, following Y90-SIRT treatment. Concurrent lenvatinib may impair mucosal repair function. This rare sequela emphasizes rigorous preoperative vascular evaluation, long-term monitoring and timely intervention, particularly for patients undergoing combined targeted treatment.