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Surgical Endoscopy

, Volume 8, Issue 10, pp 1232–1235 | Cite as

Metastatic implantation of an oral squamous-cell carcinoma at a percutaneous endoscopic gastrostomy site

  • P. Sharma
  • S. M. Berry
  • K. Wilson
  • H. Neale
  • A. S. Fink
Case Reports

Abstract

Percutaneous endoscopic gastrostomy (PEG) has become an important adjunct in the care of the head-and-neck cancer patient. When resection will likely affect swallowing, PEG can be performed just prior to cancer resection. However, it is unclear whether PEG should be the procedure of choice for establishing enteral access in head-and-neck cancer patients. In this report we describe a man with advanced oral squamous cell carcinoma who had a One-Step PEG button inserted immediately prior to his cancer resection. Six months later, the patient developed metastatic squamous-cell carcinoma at the PEG site. Although the mechanism of spread cannot be confirmed, direct seeding from passage through the cancer-filled oral cavity seems likely. Methods of establishing enteral access which avoid tumor-contaminated fields, such as use of an overtube during conventional PEG, open gastrostomy, or laparoscopic gastrostomy, may be more appropriate in head-and-neck cancer patients.

Key words

Percutaneous endoscopic gastrostomy Oral cancer Metastatic implantation 

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Copyright information

© Springer-Verlag New York Inc. 1994

Authors and Affiliations

  • P. Sharma
    • 1
  • S. M. Berry
    • 2
  • K. Wilson
    • 1
  • H. Neale
    • 2
  • A. S. Fink
    • 3
  1. 1.Department of OtolaryngologyUniversity of Cincinnati Medical CenterCincinnatiUSA
  2. 2.Department of SurgeryUniversity of Cincinnati Medical CenterCincinnatiUSA
  3. 3.Department of SurgeryEmory University and Atlanta VAMCAtlantaUSA

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