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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 4/2020

01-04-2020 | Endoscopy | Image of the Month

A case of abdominal wall percutaneous endoscopic gastrostomy site metastatic disease from primary oropharyngeal squamous cell carcinoma

Authors: S. L. Ayesa, S. F. Hain

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2020

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Excerpt

A 57-year-old female patient presented for follow-up 18F-FDG PET/CT while being treated for primary squamous cell carcinoma of the right oropharynx, which had locally recurred (d). A percutaneous endoscopic gastrostomy (PEG) tube had been inserted at the commencement of her treatment 12 months prior. Over multiple scans, there was progressive 18F-FDG uptake at the PEG site in the right anterior abdominal wall (Fig. 1a, c; long arrow), with a corresponding enlarging soft tissue mass on low-dose CT (b, short arrow). While this was initially thought to reflect infection, biopsy confirmed metastatic squamous cell carcinoma—seeded to the PEG site from the oropharynx at the time of endoscopy. …
Literature
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Grant DG, Bradley PT, Pothier DD, Bailey D, Caldera S, Baldwin DL, et al. Complications following gastrostomy tube insertion in patients with head and neck cancer: a prospective multi-institution study, systematic review and meta-analysis. Clin Otolaryngol. 2009;34(2):103–12.CrossRef
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Coletti D, Genuit T, Ord R, Engroff S. Metastasis to the percutaneous endoscopic gastrostomy site in the patient with head and neck cancer: a case report and review of the literature. J Oral Maxillofac Surg. 2006;64(7):1149–57.CrossRef
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Cruz I, Mamel JJ, Brady PG, Cass-Garcia M. Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. Gastrointest Endosc. 2005;62(5):708–11 quiz 52, 53.CrossRef
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Huang AT, Georgolios A, Espino S, Kaplan B, Neifeld J, Reiter ER. Percutaneous endoscopic gastrostomy site metastasis from head and neck squamous cell carcinoma: case series and literature review. J Otolaryngol Head Neck Surg. 2013;42(1):20.CrossRef
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Hawken RM, Williams RW, Bridger MW, Lyons CB, Jackson SA. Puncture-site metastasis in a radiologically inserted gastrostomy tube: case report and literature review. Cardiovasc Intervent Radiol. 2005;28(3):377–80.CrossRef
Metadata
Title
A case of abdominal wall percutaneous endoscopic gastrostomy site metastatic disease from primary oropharyngeal squamous cell carcinoma
Authors
S. L. Ayesa
S. F. Hain
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-020-04700-6

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