METASTATIC CARCINOMA OF THE TONGUE AT A PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SITE

Abstract

A case of metastatic carcinoma of the tongue at a percutaneous endoscopic gastrostomy (PEG) site is reported. A 61-year-old man with recurrent cancer of the tongue (rT4N2M0) underwent a PEG insertion using the "pull" technique. Four months later, the patient developed metastatic squamous cell carcinoma at the PEG site. A review of the literature revealed 29 cases of metastatic head and neck cancers to PEG site from western countries. Possible mechanisms of metastasis are direct implantation and hematogenous spread. This complication is rare and this case is the first report in Japan. However, this complication probably increase with the increase number of patients of PEG placement for head and neck cancers. Therefore, the selection of the methods of gastrostomy and the careful frequent medical examination after PEG placement should be important.