Implantação metastática em estoma de gastrostomia endoscópica percutânea

S. Barrias* ¹, P. Lago¹, C. Caetano¹, C. Nogueira², J. Areias¹

 

Resumo

A colocação de sonda por gastrostomia endoscópica percutânea é aceite como via alternativa para alimentação entérica em doentes com neoplasias obstrutivas laringofaríngeas ou esofágicas. A implantação metastática no estoma é uma complicação rara mas crescentemente referenciada na literatura, sendo importante a sua divulgação. Os autores apresentam, com iconografia, um caso de metastização de cancro esofágico para o estoma de gastrostomia endoscópica percutânea e fazem uma revisão da literatura.

 

Summary

Percutaneous endoscopic gastrostomy tube placement is a widely accepted alternative route for providing enteral nutrition in patients with laryngeal, pharyngeal or oesophageal cancer causing obstruction. Metastatic implantation to the stoma is an uncommon complication but one that is being recognized with increasing frequency; and it is important that it be reported. The authors describe a case of metastasis of an oesophageal cancer at a percutaneous endoscopic gastrostomy stoma with iconography and present a literature review.

 

Texto Completo disponível apenas em PDF

Full text only available in PDF format

 

Bibliografia

1. Gauderer MWL, Ponsky JL, Izant RT. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15: 872-75.        [ Links ]

2. American Society For Gastrointestal Endoscopy. Role of endoscopy in enteral feeding. Gastrointest Endosc 2002; 55: 794-7.

3. Mathus-Vliegen L.M.H., Koning H. Percutaneous endoscopic gastrostomy and gastrojejunostomy: a critical reappraisal of patient selection, tube function and feasibility of nutritional support during extended follow-up. Gastrointest Endosc. 1999; 50:746-54.

4. Maccabee D, Sheppard BC. Prevention of percutaneous endoscopic gastrostomy stoma metastases in patients with active oropharyngeal malignancy. Surg Endosc 2003; 17: 1678. 5. Potochny JD, Sataloff DM, Spiegel JR, Lieber CP, Siskind B, Sataloff RT. Head and neck cancer implantation at the percutaneous endoscopic gastrostomy exit site. Surg Endosc 1998; 12:1361-5.

6. Cossentino MJ, Fukuda MM, Butler JA, Sanders JW. Cancer metastasis to a percutaneous gastrostomy site. Head Neck 2001;23: 1080-3.

7. Ananth.S, Amin M. Implantation of oral squamous cell carcinoma at the site of a percutaneous endoscopic gastrostomy: a case report. Br J Oral Maxillofac Surg 2002; 40: 125-30.

8. Thermann F, Marcy T, Dralle H. Primary operative gastrostomy or percutaneous endoscopic gastrostomy in progressive oesophageal carcinomas? A case report on abdominal wall metastases following PEG. Chirug 2002; 73: 1132-5.

9. Savoye G, Le Blanc-Louvry I, Le Pessot F, Foulatier O, Lecleire S, Herve S, et. al. Metastasis to the site of percutaneous endoscopic gastrostomy tract in a patient treated for squamous cell carcinoma of the piriform sinus. Gastroenterol Clin Biol 2002;26: 795-7.

10. Kurdow R, Schniewind B, Delere Y, Boehle AS, Luttges J, Doniec JM. Implantation metastasis of a hypopharyngeal carcinoma at the site of a percutaneous endoscopic gastrostomy. Endoscopy 2003; 35: 462.

11. Thakore JN, Mustafa M, Suryaprasad S, Agrawal S. Percutaneous endoscopic gastrostomy associated gastric metastasis. J Clin Gastroenterol 2003; 37: 307-11.

12. Wacke W, Hecker U, Woenckhaus C, Lerch MM. Percutaneous endoscopic gastrostomy site metastasis in a patient with esophageal cancer. Endocopy 2004; 36: 472.

13. Raman S, Siddiq TO, Joseph A, Jones AH, Haray PN, Masoud AG. Vaccination metastasis following percutaneous endoscopic gastrostomy. Hosp Med 2004; 65: 246-7.

14. Adelson RT, Ducic Y. Metastatic head and neck carcinoma to a percutaneous endoscopic gastrostomy site. Head Neck 2005; 27:339-43.

15. Halfpenny W, McGurk, M. Stomal recurrence following temporary tracheostomy. J Laryngol Otol 2001; 115: 202-4.

 

* Correspondência:

Sílvia Barrias

Serviço de Gastrenterologia

Hospital Geral de Santo António

Largo do Prof. Abel Salazar

4099 - 001 Porto

Tel.: 222077500 ext 1372

Fax: 222088109

 

(1) Serviço de Gastrenterologia

(2) Serviço de Cirurgia 1

Hospital Geral de Santo António, Porto, Portugal.

 

Recebido para publicação: 05/12/2005

Aceite para publicação: 17/05/2006