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.
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.
Authors: Johanna Ruohoalho; Katri Aro; Antti A Mäkitie; Timo Atula; Aaro Haapaniemi; Harri Keski-Säntti; Leena Kylänpää; Annika Takala; Leif J Bäck Journal: Eur Arch Otorhinolaryngol Date: 2017-09-01 Impact factor: 2.503
Authors: Eleanor Fung; David S Strosberg; Edward L Jones; Rebecca Dettorre; Andrew Suzo; Michael P Meara; Vimal K Narula; Jeffrey W Hazey Journal: Surg Endosc Date: 2016-12-30 Impact factor: 4.584
Authors: Francesca Vincenzi; Giuseppina De Caro; Federica Gaiani; Fabiola Fornaroli; Roberta Minelli; Gioacchino Leandro; Francesco Di Mario; Gian Luigi De' Angelis Journal: Acta Biomed Date: 2018-12-17
Authors: Denise Strijbos; Daniel Keszthelyi; Lennard P L Gilissen; Martin Lacko; Janneke G J Hoeijmakers; Christiaan van der Leij; Rogier J J de Ridder; Michiel W de Haan; Ad A M Masclee Journal: Endosc Int Open Date: 2019-10-23