[Metastasis of an esophageal carcinoma at a PEG site--case report and review of the literature].

Abstract:

:We describe the case of a 54-year-old man with a tumour of the proximal esophagus (cT3-4,N1,M0), who underwent percutaneous endoscopic gastrostomy (PEG) for enteral feeding. Primary radiochemotherapy was initiated shortly after PEG insertion. Five months after PEG insertion the patient detected a nodule at the site. The general practitioner diagnosed this nodule as a brotic reaction. Another six weeks later, ulceration that had grown along the PEG probe at the PEG site was observed on gastroscopy. The primary tumour was not visible. Histological examination showed an abdominal wall metastasis of the esophageal cancer. Despite subtotal gastrectomy with en-bloc resection of the tumour, distant metastasis developed. The patient died six months after surgery. About 47 cases of abdominal wall metastases as late complications at the site have been reported until now. The mechanism of tumour spread of PEG site is a subject of controversial discussion. As direct mechanical tumour implantation is the most likely mechanism, an alternative method like operative (laparoscopic) or radiological PEG placement should be considered in cases with advanced, stenotic tumours.

journal_name

Zentralbl Chir

authors

Volkmer K,Meyer T,Sailer M,Fein M

doi

10.1055/s-0028-1098769

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

481-5

issue

5

eissn

0044-409X

issn

1438-9592

journal_volume

134

pub_type

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