Recurrent metastatic spread to a percutaneous gastrostomy site in a patient with squamous cell carcinoma of the tongue: a case report and review of the literature.
Patients diagnosed with head and neck squamous cell cancer (HNSCC) frequently develop dysphagia and odynophagia owing to advancing disease or as a result of medical interventions. Selected patients diagnosed with advanced HNSCC may require the insertion of a percutaneous endoscopic gastrostomy (PEG) tube as part of their management. During the past 2 decades, there have been increasing reports describing tumor seeding at the PEG exit site, which have caused controversy relating to the technique used in PEG insertion. Although PEG placement is considered a safe procedure for patients with advanced head and neck cancer, the method can lead to tumor seeding, probably from direct traumatic tumor shedding. This report describes a case of tumor implantation at the PEG site in a patient with an advanced SCC of the tongue, with a review of the available literature concerning this rare condition and its possible pathogenesis.
Resident, Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2012, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Electronic address: Avinoam.Nevler@sheba.health.gov.il.
Avinoam
A
Nevler
Director of Head and Neck Service, Radiotherapy Unit, Institute of Oncology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Iris
I
Gluck
Resident, Department of Pathology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Nora
N
Balint-Lahat
Senior Surgeon, Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Danny
D
Rosin
D000009:Abdominal Muscles / Q000473:pathology*; D000008:Abdominal Neoplasms / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary*; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D012086:Reoperation; D014062:Tongue Neoplasms / Q000473:pathology*