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[Metastasis of an esophageal carcinoma at a PEG site--case report and review of the literature].
Zentralbl Chir. 2009 Sep; 134(5):481-5.ZC

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.

Authors+Show Affiliations

Chirurgische Klinik, Klinikum Bremen-Nord, Bremen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article
Review

Language

ger

PubMed ID

19757350

Citation

Volkmer, K, et al. "[Metastasis of an Esophageal Carcinoma at a PEG Site--case Report and Review of the Literature]." Zentralblatt Fur Chirurgie, vol. 134, no. 5, 2009, pp. 481-5.
Volkmer K, Meyer T, Sailer M, et al. [Metastasis of an esophageal carcinoma at a PEG site--case report and review of the literature]. Zentralbl Chir. 2009;134(5):481-5.
Volkmer, K., Meyer, T., Sailer, M., & Fein, M. (2009). [Metastasis of an esophageal carcinoma at a PEG site--case report and review of the literature]. Zentralblatt Fur Chirurgie, 134(5), 481-5. https://doi.org/10.1055/s-0028-1098769
Volkmer K, et al. [Metastasis of an Esophageal Carcinoma at a PEG Site--case Report and Review of the Literature]. Zentralbl Chir. 2009;134(5):481-5. PubMed PMID: 19757350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Metastasis of an esophageal carcinoma at a PEG site--case report and review of the literature]. AU - Volkmer,K, AU - Meyer,T, AU - Sailer,M, AU - Fein,M, Y1 - 2009/09/15/ PY - 2009/9/17/entrez PY - 2009/9/17/pubmed PY - 2009/12/16/medline SP - 481 EP - 5 JF - Zentralblatt fur Chirurgie JO - Zentralbl Chir VL - 134 IS - 5 N2 - 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. SN - 1438-9592 UR - https://www.unboundmedicine.com/medline/citation/19757350/[Metastasis_of_an_esophageal_carcinoma_at_a_PEG_site__case_report_and_review_of_the_literature]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0028-1098769 DB - PRIME DP - Unbound Medicine ER -