Seeding of the percutaneous endoscopic gastrostomy site from head and neck carcinoma: case report and review of the literature.
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.


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.
Department of Medical Oncology, Cliniques universitaires St-Luc, Centre du cancer, Université Catholique de Louvain, Brussels, Belgium.
I
I
Sinapi
B
B
Navez
M
M
Hamoir
S
S
Schmitz
J P
JP
Machiels
P H
PH
Deprez
M
M
Van den Eynde
D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D005773:Gastroscopy / Q000009:adverse effects; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D013274:Stomach Neoplasms / Q000556:secondary*