Abdalla Monzer, Saad Eltaib, Abdalla Mohammed S, Faris Mohammed Elamin, Abdulrahman Ahmed A, Mohamed Khalid, Abdulrahman Ahmed M, Mustafa Abdurrahman, Fillipuk Dorota
Department of Internal Medicine, Ascension Saint Francis Hospital, Evanston, IL, USA.
Department of Pathology, Ascension Saint Francis Hospital, Evanston, IL, USA.
J Med Cases. 2023 Mar;14(3):100-104. doi: 10.14740/jmc4059. Epub 2023 Mar 31.
Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure that represents an important supportive adjunctive component for patients with primary head and neck squamous cell carcinoma (HNSCC). The HNSCC population is considered a high-risk group for developing critical nutritional deficiency due to a multitude of factors. Nevertheless, as the use of PEG in modern practice is gaining more popularity due to various indications, unusual complications have been increasingly reported. PEG site metastasis from primary HNSCC has emerged as a rare, yet serious oncological phenomenon that warrants careful consideration. The authors report an unusual case of squamous cell carcinoma (SCC) of the hypopharynx that metastasized to the gastric body mucosa through a PEG site. The metastatic SCC presented as massive gastrointestinal bleeding, and esophagogastroscopy revealed an ulcerated mass in the gastric body masquerading as a primary gastric adenocarcinoma. Histopathology and immunohistochemistry examination confirmed metastatic SCC which concurred with the patient's primary hypopharyngeal SCC. The review of the updated literature revealed that a total of 121 cases of this rare oncological entity have been reported to date. Physicians need to be vigilant of the symptoms of PEG site metastasis to accurately diagnose and manage the care of this rare occurrence as it is associated with poor prognosis.
经皮内镜下胃造口术（PEG）是一种相对安全的手术，是原发性头颈部鳞状细胞癌（HNSCC）患者重要的支持性辅助手段。由于多种因素，HNSCC患者群体被认为是发生严重营养缺乏的高危人群。然而，随着PEG在现代临床实践中的应用因各种适应症而越来越普遍，不寻常的并发症报告也日益增多。原发性HNSCC经PEG部位转移已成为一种罕见但严重的肿瘤学现象，值得仔细考虑。作者报告了一例下咽鳞状细胞癌（SCC）经PEG部位转移至胃体黏膜的罕见病例。转移性SCC表现为大量胃肠道出血，食管胃镜检查发现胃体有一个溃疡肿块，伪装成原发性胃腺癌。组织病理学和免疫组织化学检查证实为转移性SCC，与患者原发性下咽SCC一致。对最新文献的回顾显示，迄今为止共报告了121例这种罕见的肿瘤实体病例。医生需要警惕PEG部位转移的症状，以便准确诊断和处理这种罕见情况，因为它与预后不良有关。
