Journal Article Resected tumor seeding in stomach wall due to endoscopic ultrasonography-guided fine needle aspiration of pancreatic adenocarcinoma

Tomonari, Akiko  ,  Katanuma, Akio  ,  Matsumori, Tomoaki  ,  Yamazaki, Hajime  ,  Sano, Itsuki  ,  Minami, Ryuki  ,  Sen-yo, Manabu  ,  Ikarashi, Satoshi  ,  Kin, Toshifumi  ,  Yane, Kei  ,  Takahashi, Kuniyuki  ,  Shinohara, Toshiya  ,  Maguchi, Hiroyuki

21 ( 27 )  , pp.8458 - 8461 , 2015-07-21 , WJG Press
Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is a useful and relatively safe tool for the diagnosis and staging of pancreatic cancer. However, there have recently been several reports of tumor seeding after EUS-FNA of adenocarcinomas. A 78-year-old man was admitted to our hospital due to upper gastric pain. Examinations revealed a 20 mm mass in the pancreatic body, for which EUS-FNA was performed. The cytology of the lesion was adenocarcinoma, and the stage of the cancer was T3N0M0. The patient underwent surgery with curative intent, followed by adjuvant chemotherapy with S-1. An enlarging gastric submucosal tumor was found on gastroscopy at 28 mo after surgery accompanied by a rising level of CA19-9. Biopsy result was adenocarcinoma, consistent with a pancreatic primary tumor. Tumor seeding after EUS-FNA was strongly suspected. The patient underwent surgical resection of the gastric tumor with curative intent. The pathological result of the resected gastric specimen was adenocarcinoma with a perfectly matched mucin special stain result with the previously resected pancreatic cancer. This is the first case report of tumor seeding after EUS-FNA which was surgically resected and inspected pathologically.

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