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Metastasis of untreated head and neck cancer to percutaneous gastrostomy tube exit sites.
Am J Otolaryngol. 2012 Nov-Dec; 33(6):774-8.AJ

Abstract

BACKGROUND

Percutaneous endoscopic gastrostomy (PEG) has become a mainstay in providing enteral access for patients with obstructive head and neck tumors. PEG tube placement is considered safe and complications are infrequent.

METHODS

A comprehensive review of the literature in MEDLINE (1962-2011) was performed. We report herein 3 new cases.

RESULTS

The literature search revealed 43 previous cases. The interval between PEG placement and diagnosis of metastasis ranged from 1 to 24 months.

CONCLUSIONS

Metastatic cancer should be considered in patients with head and neck cancer that have persistent, unexplained skin changes at PEG site, anemia, or guaiac positive stools without a clear etiology. The direct implantation of tumor cells through instrumentation is the most likely explanation, although hematogenous and/or lymphatic seeding is also a possibility. Our review of the literature and clinical experience indicate that the "pull" technique of PEG placement may directly implant tumor cells at the gastrostomy site.

Authors+Show Affiliations

OSF Saint Anthony Medical Center, University of Illinois, College of Medicine at Rockford, IL, USA. kianoush@uic.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

22917953

Citation

Sheykholeslami, Kianoush, et al. "Metastasis of Untreated Head and Neck Cancer to Percutaneous Gastrostomy Tube Exit Sites." American Journal of Otolaryngology, vol. 33, no. 6, 2012, pp. 774-8.
Sheykholeslami K, Thomas J, Chhabra N, et al. Metastasis of untreated head and neck cancer to percutaneous gastrostomy tube exit sites. Am J Otolaryngol. 2012;33(6):774-8.
Sheykholeslami, K., Thomas, J., Chhabra, N., Trang, T., & Rezaee, R. (2012). Metastasis of untreated head and neck cancer to percutaneous gastrostomy tube exit sites. American Journal of Otolaryngology, 33(6), 774-8. https://doi.org/10.1016/j.amjoto.2012.07.006
Sheykholeslami K, et al. Metastasis of Untreated Head and Neck Cancer to Percutaneous Gastrostomy Tube Exit Sites. Am J Otolaryngol. 2012 Nov-Dec;33(6):774-8. PubMed PMID: 22917953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metastasis of untreated head and neck cancer to percutaneous gastrostomy tube exit sites. AU - Sheykholeslami,Kianoush, AU - Thomas,Jacob, AU - Chhabra,Nipun, AU - Trang,Tung, AU - Rezaee,Rod, Y1 - 2012/08/20/ PY - 2012/07/10/received PY - 2012/07/16/accepted PY - 2012/8/25/entrez PY - 2012/8/25/pubmed PY - 2013/5/8/medline SP - 774 EP - 8 JF - American journal of otolaryngology JO - Am J Otolaryngol VL - 33 IS - 6 N2 - BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) has become a mainstay in providing enteral access for patients with obstructive head and neck tumors. PEG tube placement is considered safe and complications are infrequent. METHODS: A comprehensive review of the literature in MEDLINE (1962-2011) was performed. We report herein 3 new cases. RESULTS: The literature search revealed 43 previous cases. The interval between PEG placement and diagnosis of metastasis ranged from 1 to 24 months. CONCLUSIONS: Metastatic cancer should be considered in patients with head and neck cancer that have persistent, unexplained skin changes at PEG site, anemia, or guaiac positive stools without a clear etiology. The direct implantation of tumor cells through instrumentation is the most likely explanation, although hematogenous and/or lymphatic seeding is also a possibility. Our review of the literature and clinical experience indicate that the "pull" technique of PEG placement may directly implant tumor cells at the gastrostomy site. SN - 1532-818X UR - https://www.unboundmedicine.com/medline/citation/22917953/Metastasis_of_untreated_head_and_neck_cancer_to_percutaneous_gastrostomy_tube_exit_sites_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0709(12)00141-X DB - PRIME DP - Unbound Medicine ER -