Gastric metastases of oral carcinoma resulting from percutaneous endoscopic gastrostomy placement via the introducer technique

Introduction. Tumour cell implantation is a rare complication in patients with headand neck cancers, who have undergone percutaneous endoscopic gastrostomy(PEG) tube placement. It has not been reported in patients who underwent a PEG insertion via the radiological or introducer technique. We describe a novel case presentation of metastatic disease in a patient who underwent PEG placement via the introducer (Russell) technique which, to the best of our knowledge, has not not previously been described. Case presentation. The patient was a 37-year-old Malay woman who developed metastatic squamous cell carcinoma deposits in her stomach and liver one month after a gastrostomytube was removed following the completion of treatment for oropharyngeal carcinoma. Conclusion. Previous authors have advocated the use of alternative PEG insertion technique apart from the ‘pull’ technique to minimise the risk of tumour implantation from headand neck cancers. Our case report suggests that this risk is not totally eliminated when the PEG tube is inserted via the introducer technique. Keyword: endoscopic gastrostomy.