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Metastasis of head and neck carcinoma to the site of percutaneous endoscopic gastrostomy: case report and literature review.
JPEN J Parenter Enteral Nutr. 2001 Sep-Oct; 25(5):282-5.JJ

Abstract

BACKGROUND

Patients with head and neck cancer often need a percutaneous endoscopic gastrostomy to provide adequate nutrition because of inability to swallow after tumor radiation therapy. However, metastasis of the original tumor to the gastrostomy exit site may occur.

METHODS

We describe the case of a 61-year-old man with stage III (T2 N1) squamous cell carcinoma of the tongue in whom a PEG tube was placed to circumvent anticipated difficulties in swallowing after radiation therapy. We also compare this case with similar cases in the literature.

RESULTS

Soreness and erythema near the gastrostomy site reported by the patient were diagnosed as cellulitis, and two courses of antibiotic treatment were prescribed. However, a biopsy showed that the original squamous cell carcinoma had metastasized to the gastrostomy exit site. The "pull" method of tube placement had been used in this patient and in all 19 cases of metastasis reported in the literature.

CONCLUSIONS

Metastatic cancer should be considered in patients with head and neck cancer who have unexplained skin changes at the gastrostomy site. Our experience with this case and review of the literature indicate that, in patients with head and neck cancer, "pull" procedures for placement of gastrostomy tubes may induce metastasis by direct implantation of tumor cells because of contact between the gastrostomy tube and tumor cells. Methods of tube insertion that avoid such contact are preferred.

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Authors+Show Affiliations

Sinclair JJ
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida 32224, USA.
Scolapio JS
No affiliation info available
Stark ME
No affiliation info available
Hinder RA
No affiliation info available

MeSH

Carcinoma, Squamous CellGastrostomyHumansMaleMiddle AgedNeoplasm SeedingStomach NeoplasmsTongue Neoplasms

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11531220

Citation

Sinclair, J J., et al. "Metastasis of Head and Neck Carcinoma to the Site of Percutaneous Endoscopic Gastrostomy: Case Report and Literature Review." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 25, no. 5, 2001, pp. 282-5.
Sinclair JJ, Scolapio JS, Stark ME, et al. Metastasis of head and neck carcinoma to the site of percutaneous endoscopic gastrostomy: case report and literature review. JPEN J Parenter Enteral Nutr. 2001;25(5):282-5.
Sinclair, J. J., Scolapio, J. S., Stark, M. E., & Hinder, R. A. (2001). Metastasis of head and neck carcinoma to the site of percutaneous endoscopic gastrostomy: case report and literature review. JPEN. Journal of Parenteral and Enteral Nutrition, 25(5), 282-5.
Sinclair JJ, et al. Metastasis of Head and Neck Carcinoma to the Site of Percutaneous Endoscopic Gastrostomy: Case Report and Literature Review. JPEN J Parenter Enteral Nutr. 2001 Sep-Oct;25(5):282-5. PubMed PMID: 11531220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metastasis of head and neck carcinoma to the site of percutaneous endoscopic gastrostomy: case report and literature review. AU - Sinclair,J J, AU - Scolapio,J S, AU - Stark,M E, AU - Hinder,R A, PY - 2001/9/4/pubmed PY - 2002/1/23/medline PY - 2001/9/4/entrez SP - 282 EP - 5 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 25 IS - 5 N2 - BACKGROUND: Patients with head and neck cancer often need a percutaneous endoscopic gastrostomy to provide adequate nutrition because of inability to swallow after tumor radiation therapy. However, metastasis of the original tumor to the gastrostomy exit site may occur. METHODS: We describe the case of a 61-year-old man with stage III (T2 N1) squamous cell carcinoma of the tongue in whom a PEG tube was placed to circumvent anticipated difficulties in swallowing after radiation therapy. We also compare this case with similar cases in the literature. RESULTS: Soreness and erythema near the gastrostomy site reported by the patient were diagnosed as cellulitis, and two courses of antibiotic treatment were prescribed. However, a biopsy showed that the original squamous cell carcinoma had metastasized to the gastrostomy exit site. The "pull" method of tube placement had been used in this patient and in all 19 cases of metastasis reported in the literature. CONCLUSIONS: Metastatic cancer should be considered in patients with head and neck cancer who have unexplained skin changes at the gastrostomy site. Our experience with this case and review of the literature indicate that, in patients with head and neck cancer, "pull" procedures for placement of gastrostomy tubes may induce metastasis by direct implantation of tumor cells because of contact between the gastrostomy tube and tumor cells. Methods of tube insertion that avoid such contact are preferred. SN - 0148-6071 UR - https://www.unboundmedicine.com/medline/citation/11531220/Metastasis_of_head_and_neck_carcinoma_to_the_site_of_percutaneous_endoscopic_gastrostomy:_case_report_and_literature_review_ L2 - https://doi.org/10.1177/0148607101025005282 DB - PRIME DP - Unbound Medicine ER -