A Case of Curative Resection of Needle Tract Seeding after EUS-guided Fine Needle Aspiration for Pancreatic Body Cancer

Abstract

A 67-year-old woman was referred to our hospital for further evaluation of a submucosal tumor (SMT) located at the posterior wall of the stomach. She had undergone distal pancreatectomy 22 months prior for pancreatic body cancer diagnosed using trans-gastric endoscopic-guided fine needle aspiration (EUS-FNA).
Esophagogastroduodenoscopy revealed that the SMT was located very close to the puncture site of the previous EUS-FNA. In addition, a biopsy specimen of the SMT demonstrated tubular adenocarcinoma resembling the resected pancreatic body cancer. Needle tract seeding (NTS) of the pancreatic cancer to the gastric wall was suspected, and we performed partial resection of the stomach. The immunohistochemical staining pattern of the SMT was completely consistent with the resected pancreatic cancer, indicating NTS caused by EUS-FNA.
Although NTS is a very rare complication of EUS-FNA, careful attention should be paid to the gastric wall after distal pancreatectomy in patients who were previously diagnosed by trans-gastric EUS-FNA.