Needle tract seeding following endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer: a report of two cases

Autor: Yoshihumi Nakamura, Hiroki Nakahashi, Shuji Isaji, Yuta Shomi, Michiaki Oiwa, Koji Katsuta, Kentaro Taniguchi, Shota Tanaka, Yuji Haruki, Hiroki Yukimoto, Toshiki Matsui, Makoto Shimomura, Kenichiro Nishikawa
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Endoscopic ultrasound
Male
medicine.medical_specialty
medicine.medical_treatment
Splenectomy
lcsh:Surgery
Needle tract seeding
Case Report
Gastric wall metastasis
lcsh:RC254-282
Metastasis
03 medical and health sciences
0302 clinical medicine
Neoplasm Seeding
Stomach Neoplasms
Pancreatic cancer
Endoscopic ultrasound-guided fine-needle aspiration
medicine
Humans
Needle Tract Seeding
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Aged
medicine.diagnostic_test
business.industry
lcsh:RD1-811
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
digestive system diseases
Pancreatic Neoplasms
Fine-needle aspiration
Oncology
030220 oncology & carcinogenesis
Surgical resection
Adenocarcinoma
030211 gastroenterology & hepatology
Surgery
Gastrectomy
Female
Radiology
business
Zdroj: World Journal of Surgical Oncology, Vol 17, Iss 1, Pp 1-8 (2019)
World Journal of Surgical Oncology
ISSN: 1477-7819
DOI: 10.1186/s12957-019-1681-x
Popis: Background Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a useful tool in pancreatic cancer diagnosis. However, the procedure itself may cause peritoneal dissemination and needle tract seeding at the puncture site. We herein report two cases of gastric wall metastasis due to needle tract seeding after EUS-FNA. Case presentation Case 1: A 68-year-old woman was admitted to our hospital for persistent cough. Computed tomography (CT) scan revealed inflammatory changes in the left lung field, and incidentally, a 15-mm hypovascular mass was detected in the pancreatic body. She underwent EUS-FNA and was diagnosed as pancreatic adenocarcinoma. She underwent distal pancreatectomy with splenectomy; however, a small hard mass was observed in the posterior gastric wall during surgery. We performed partial gastrectomy, and the resected specimen was diagnosed as a needle tract seeding following EUS-FNA. She then underwent adjuvant chemotherapy with TS-1, but the pancreatic cancer showed recurrence 6 months after surgery. She died due to peritoneal dissemination 18 months after surgery. Case 2: A 70-year-old man was incidentally detected with a pancreatic body mass on a CT scan as part of his follow-up for recurrence of basal cell carcinoma. He underwent EUS-FNA and was diagnosed as pancreatic adenocarcinoma. He had nodules in both lungs, and it was difficult to differentiate them from lung metastasis of pancreatic cancer. Therefore, he underwent neoadjuvant chemoradiotherapy, and thereafter, the lung nodules showed no changes; hence, he underwent distal pancreatectomy with splenectomy. During surgery, we observed a hard mass in the posterior gastric wall. We performed partial gastrectomy, and the resected specimen was diagnosed as needle tract seeding due to EUS-FNA. He underwent chemotherapy with TS-1, and he is still alive 18 months after surgery at the time of writing. Conclusion For resectable pancreatic body or tail tumors, EUS-FNA should be carefully performed to prevent needle tract seeding and intraoperative as well as postoperative assessment for gastric wall metastasis is mandatory.
Databáze: OpenAIRE
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