Bauchdeckenmetastasen als Komplikation der PEG-Anlage bei Karzinomen des oberen Aerodigestivtraktes

Percutaneous endoscopic gastrostomy (PEG) has become an important adjunct in the care of head and neck cancer patients. In the literature of the last 10 years, 16 cases of abdominal wall metastasis after PEG implantation were reported. We performed 387 PEG procedures in patients with head and neck cancers. In this paper, we describe two patients with advanced head and neck cancers who underwent PEG prior to cancer therapy and developed metastatic cancer at the PEG site 3 or 4 months later. Although the mechanism of spread cannot be confirmed,direct seeding from passage through the cancer seems likely. Methods of establishing enteral access which avoid tumor-contaminated fields, such as the use of an overtube during conventional PEG or PEG procedure after tumor resection, may be appropriate in head and neck cancer patients. Another possibility of origin is the hematogenous spread of cancer cells from metastases on the abdominal wall.