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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.<\/jats:p>","DOI":"10.3389\/fonc.2026.1928806","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:37:46Z","timestamp":1790656666000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A case of delayed-onset benign distal esophageal stricture after Yttrium-90 microsphere selective internal radiation therapy"],"prefix":"10.3389","volume":"16","author":[{"given":"Yang","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Weifang People's Hospital, The First Affiliated Hospital of Shandong Second Medical University","place":["Weifang, 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