Meurer M F, Kenady D E
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084.
Head Neck. 1993 Jan-Feb;15(1):70-3. doi: 10.1002/hed.2880150116.
Two unusual cases of metastatic head and neck carcinoma to the exit site of a percutaneous endoscopic gastrostomy (PEG) tube are reported. These patients presented with squamous cell carcinomas of the supraglottic larynx and oropharynx. In both patients, a PEG tube was inserted using the "pull" technique prior to any extirpative measures. Within 9 months after surgical treatment, each patient was diagnosed with metastatic squamous cell carcinoma at the PEG tube exit site. A review of the literature revealed three cases of metastatic head and neck neoplasms to a PEG site and a single case report of spread to the wound of an "open" gastrostomy. The hematogenous route is the probable mechanism of metastasis, but direct implantation cannot be dismissed. Until further data become available, the authors recommend that, when possible, PEG tube placement using the "pull" technique be deferred until after extirpation of head and neck tumors.
报告了两例经皮内镜下胃造口术（PEG）置管处发生转移性头颈部癌的罕见病例。这些患者表现为声门上喉和口咽的鳞状细胞癌。在这两名患者中，在采取任何切除措施之前均采用“拉”技术插入了PEG管。手术治疗后9个月内，每名患者均被诊断为PEG管置管处转移性鳞状细胞癌。文献回顾显示有3例头颈部肿瘤转移至PEG部位，另有1例报告肿瘤播散至“开放”胃造口术的伤口。血行转移可能是转移机制，但直接种植也不能排除。在获得更多数据之前，作者建议，在可能的情况下，采用“拉”技术放置PEG管应推迟到头颈部肿瘤切除术后。
