ABDOMINAL-WALL METASTASIS FOLLOWING PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

Percutaneous endoscopic gastrostomy (PEG) has become a widely used met hod for nutritional support, particularly in patients with advanced he ad and neck carcinomas. Since the method is easy and widely establishe d it is necessary to assess possible complications, even rare ones. In this paper we report on two patients with vaccination metastasis foll owing PEG insertion. Both patients had advanced squamous cell carcinom a of the head and neck or the upper esophagus. In three patients previ ous bougienage was performed, because of considerable stenosis of the pharynx and/or esophagus. Fast-growing metastases were found at the si te of PEG insertion. with and without involvement of the gastric wall. In neither case was abdominal wall metastasis the cause of death, The re is a small but definite risk of tumor seeding into the abdominal wa ll after PEG insertion for obstructive malignant tumors. The clinical impact of this finding, however, is still undefined and needs further investigation.