Needle tract seeding of the gastric wall after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic body cancer: a case report

Abstract

A 79-year-old male patient was referred to our department for the evaluation of a pancreatic body tumor, which was detected incidentally on contrast-enhanced computed abdominal tomography. An EUS-FNA was performed for the tumor via the trans-gastric approach. Based on the findings, pancreatic adenocarcinoma was diagnosed. The patient underwent a distal pancreatectomy and a splenectomy. At postoperative 18 months, he experienced upper abdominal pain and underwent gastroendoscopy, which revealed a submucosal tumor on the posterior gastric wall and needle tract seeding of the pancreatic cancer. He received chemotherapy, but his general condition gradually deteriorated, and he died at postoperative two years due to infectious pneumonia. Needle tract seeding is a serious complication of EUS-FNA and should be seriously considered as a possibility in patients who have undergone an EUS-FNA via the gastric-wall approach. Furthermore, the indications for EUS-FNA should be weighed carefully if a pancreatic tumor, especially in the pancreatic body or tail, has already been diagnosed via another modality.