Seeding of the percutaneous endoscopic gastrostomy site from head and neck carcinoma: Case report and review of the literature

• Published in: Head & neck 2013-07, Vol.35 (7), p.E209-E212
• Main Authors: Sinapi, I., Navez, B., Hamoir, M., Schmitz, S., Machiels, J. P., Deprez, P. H., Van den Eynde, M.
• Format: Article
• Language: English
• Subjects: Carcinoma, Squamous Cell - secondary; case report; Gastroscopy - adverse effects; Gastrostomy - adverse effects; Gastrostomy - methods; head and neck squamous cell carcinoma; Humans; Hypopharyngeal Neoplasms - pathology; Male; Middle Aged; Neoplasm Seeding; percutaneous endoscopic gastrostomy; review; Stomach Neoplasms - secondary; tumor seeding
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.23015

Background Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure and is an important supportive treatment for patients with advanced head and neck cancer. Although tumor seeding has been reported in various sites, seeding at the PEG exit site is a rare complication. Methods and Results We describe a clinical case in which squamous cell carcinoma of the hypopharynx implanted at the site of PEG insertion and was successfully removed by surgery. PEG was previously placed by the “pull” technique. A review of the literature, discussion of the mechanism of spread, and recommendations to avoid this complication are discussed. Conclusions To avoid this rare and poor prognostic complication, the “pull” technique should be avoided for PEG placement in any patient with head and neck squamous cell carcinoma. An alternative method such as the “push” technique should be preferred. © 2012 Wiley Periodicals, Inc. Head Neck, 2013