Needle tract seeding recurrence of pancreatic cancer in the gastric wall with paragastric lymph node metastasis after endoscopic ultrasound-guided fine needle aspiration followed by pancreatectomy: a case report and literature review

Autor: Katsunori Furukawa, Nami Sato, Daisuke Suzuki, Nozomu Sakai, Tsukasa Takayashiki, Shigetsugu Takano, Naoya Kato, Satoshi Kuboki, Rintaro Mikata, Eri Nakadai, Hideyuki Yoshitomi, Masayuki Ohtsuka, Shingo Kagawa, Takashi Mishima
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Endoscopic ultrasound
medicine.medical_specialty
medicine.medical_treatment
Needle tract seeding
Case Report
03 medical and health sciences
0302 clinical medicine
Neoplasm Seeding
Pancreatectomy
Postoperative Complications
Pancreatic tumor
Recurrence
Stomach Neoplasms
Pancreatic cancer
Submucosa
medicine
Humans
Needle Tract Seeding
lcsh:RC799-869
Aged
80 and over
Endoscopic ultrasound-guided fine needle aspiration
Lymph node metastasis
medicine.diagnostic_test
business.industry
Stomach
Gastroenterology
General Medicine
medicine.disease
Pancreatic Neoplasms
Fine-needle aspiration
medicine.anatomical_structure
030220 oncology & carcinogenesis
Lymphatic Metastasis
Adenocarcinoma
030211 gastroenterology & hepatology
lcsh:Diseases of the digestive system. Gastroenterology
Female
Radiology
Lymph Nodes
Neoplasm Recurrence
Local
business
Zdroj: BMC Gastroenterology
BMC Gastroenterology, Vol 20, Iss 1, Pp 1-7 (2020)
ISSN: 1471-230X
Popis: Background Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has high accuracy and a low complication rate; therefore, it has been widely used as a useful tool for diagnosis of and to determine treatment strategies for pancreatic tumors. Recently, reports of the recurrence of needle tract seeding after EUS-FNA are emerging. Case presentation An 83-year-old woman was referred to our hospital to undergo further examination of her pancreatic tumor. Multidetector computed tomography (MDCT) revealed a 25-mm-diameter mass in the pancreatic body. She underwent EUS-FNA (transgastric, 22-G needle, 2 passes) and was subsequently diagnosed with adenocarcinoma. Distal pancreatosplenectomy followed by adjuvant chemotherapy with S-1 for 6 months was performed. The level of carbohydrate antigen 19–9 gradually increased 22 months after surgery, and MDCT, which was performed 3 months later, revealed a 23-mm low-density mass in the stomach and paragastric lymph node swelling. Gastroendoscopy revealed a submucosal tumor, and endoscopic ultrasound revealed a hypoechoic mass in the submucosa of the gastric wall. Partial gastrectomy with lymph node resection was performed. The pathological findings showed adenocarcinoma extending from the subserosa to the submucosa and lymph node metastasis, consistent with a tumor recurrence from the resected pancreatic tumor. She received adjuvant chemotherapy with S-1; recurrence was not observed for 5 months, at the time of this writing. Conclusion It is important to pay careful attention to the development of needle tract seeding in patients with pancreatic cancer diagnosed by EUS-FNA. This is the first case of needle tract seeding with lymph node metastasis, highlighting the need for caution and providing novel insight in the postoperative follow-up of patients with pancreatic body/tail cancer.
Databáze: OpenAIRE
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