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经皮内镜下胃造口术后胃造瘘道转移表现为食管鳞状细胞癌患者腹壁巨大肿块：一例报告

Gastrostomy tract metastasis presenting as a large abdominal wall mass following percutaneous endoscopic gastrostomy for esophageal squamous cell carcinoma: a case report.

作者信息

Leelapatanadit Jirat, Waratchanont Rawat, Asanprakit Wichitra, Kaewkangsadan Viriya, Satthaporn Sukchai

机构信息

Department of Surgery, Phramongkutklao Hospital, Thung Phaya Thai, Ratchathewi, Bangkok, Thailand.

出版信息

J Surg Case Rep. 2025 Jul 13;2025(7):rjaf510. doi: 10.1093/jscr/rjaf510. eCollection 2025 Jul.

DOI:10.1093/jscr/rjaf510
PMID:40656156
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12256108/
Abstract

Percutaneous endoscopic gastrostomy (PEG) is a standard method for providing enteral access in patients with obstructive aerodigestive cancer. However, gastrostomy tract metastasis is a rare but devastating complication in patient with aerodigestive cancers who have undergone PEG tube placement. Due to its rarity, the standard therapeutic approach remains undefined. We report the case of an 83-year-old male who developed gastrostomy tract metastasis following pull-type PEG tube placement, presenting as a large abdominal wall mass detected during surveillance following definite chemoradiation for locally advanced thoracic esophageal squamous cell carcinoma. The patient underwent en bloc resection of the abdominal wall mass along with the PEG tube. The abdominal wall defect was closed using an inter-layer polyglactin mesh repair, followed by delayed split-thickness skin grafting.

摘要

经皮内镜下胃造口术（PEG）是为患有阻塞性气消化道癌的患者提供肠内营养通路的标准方法。然而，胃造口道转移是接受PEG管置入的气消化道癌患者中一种罕见但具有毁灭性的并发症。由于其罕见性，标准的治疗方法仍未明确。我们报告了一例83岁男性患者，在置入拖式PEG管后发生胃造口道转移，表现为在局部晚期胸段食管鳞状细胞癌明确放化疗后的监测期间发现的巨大腹壁肿块。患者接受了腹壁肿块与PEG管的整块切除。使用层间聚乙醇酸网片修复关闭腹壁缺损，随后进行延迟性断层皮片移植。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/5c6277dd1f82/rjaf510f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/92aced0b26c2/rjaf510f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/945db4931c19/rjaf510f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/6d099498518f/rjaf510f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/a8ef7a570b57/rjaf510f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/14cd9fb9a2b1/rjaf510f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/a423768102d0/rjaf510f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/5c6277dd1f82/rjaf510f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/92aced0b26c2/rjaf510f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/945db4931c19/rjaf510f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/6d099498518f/rjaf510f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/a8ef7a570b57/rjaf510f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/14cd9fb9a2b1/rjaf510f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/a423768102d0/rjaf510f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa7/12256108/5c6277dd1f82/rjaf510f7.jpg

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本文引用的文献

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Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy.经皮内镜下胃造口术临床实践指南。
Gut Liver. 2024 Jan 15;18(1):10-26. doi: 10.5009/gnl230146. Epub 2023 Oct 18.
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Prevention and management of major complications in percutaneous endoscopic gastrostomy.经皮内镜胃造口术主要并发症的预防和处理。
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Isolated oesophageal adenocarcinoma metastasis at percutaneous endoscopic gastrostomy (PEG) site.经皮内镜下胃造口术（PEG）部位孤立性食管腺癌转移
BMJ Case Rep. 2020 Jun 30;13(6):e236778. doi: 10.1136/bcr-2020-236778.
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Gastrointest Endosc. 2020 May;91(5):1005-1014.e17. doi: 10.1016/j.gie.2019.12.045. Epub 2020 Jan 8.
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Prospective evaluation of malignant cell seeding after percutaneous endoscopic gastrostomy in patients with oropharyngeal/esophageal cancers.经皮内镜胃造瘘术后口咽/食管恶性肿瘤患者癌细胞种植的前瞻性评估。
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Percutaneous endoscopic gastrostomy site metastasis from head and neck squamous cell carcinoma: case series and literature review.经皮内镜胃造口术部位转移来自头颈部鳞状细胞癌：病例系列和文献复习。
J Otolaryngol Head Neck Surg. 2013 Feb 28;42(1):20. doi: 10.1186/1916-0216-42-20.