Tomonari A, Katanuma A, Matsumori T, Yamazaki H, Sano I, Minami R, Sen-yo M, Ikarashi S, Kin T, Yane K, Takahashi K, Shinohara T, Maguchi H. Resected tumor seeding in stomach wall due to endoscopic ultrasonography-guided fine needle aspiration of pancreatic adenocarcinoma. World J Gastroenterol 2015; 21(27): 8458-8461 [PMID: 26217099 DOI: 10.3748/wjg.v21.i27.8458]
Corresponding Author of This Article
Akiko Tomonari, MD, Center for Gastroenterology, Teine-Keijinkai Hospital, 1-12-1-40 Maeda, Teine-ku, Sapporo 006-8555, Japan. narinarinarii@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Akiko Tomonari, Akio Katanuma, Hajime Yamazaki, Itsuki Sano, Ryuki Minami, Manabu Sen-yo, Satoshi Ikarashi, Toshifumi Kin, Kei Yane, Kuniyuki Takahashi, Hiroyuki Maguchi, Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo 006-8555, Japan
Tomoaki Matsumori, Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
Toshiya Shinohara, Department of Pathology, Teine-Keijinkai Hospital, Sapporo 006-8555, Japan
Author contributions: All authors helped to perform the research; Tomonari A wrote the paper; all authors have approved the final draft of the manuscript.
Institutional review board statement: Teine-keijinkei Hospital Institutional Review Board for Conduction and Submission of the study.
Informed consent statement: The patient provided informed consent prior to study enrollment.
Conflict-of-interest statement: To the best of our knowledge, no conflict of interest, financial or other, exists to any authors listed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Akiko Tomonari, MD, Center for Gastroenterology, Teine-Keijinkai Hospital, 1-12-1-40 Maeda, Teine-ku, Sapporo 006-8555, Japan. narinarinarii@yahoo.co.jp
Telephone: +81-11-6818111 Fax: +81-11-6852967
Received: December 21, 2014 Peer-review started: December 22, 2014 First decision: January 8, 2015 Revised: February 10, 2015 Accepted: March 27, 2015 Published online: July 21, 2015 Processing time: 212 Days and 20.6 Hours
Abstract
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.
Core tip: This manuscript is the first case report about tumor seeding after endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) which was surgically resected and inspected pathologically. EUS-FNA is a widely performed procedure; however, there are no clear guidelines indicating the selection of treatments in cases of tumor seeding after the procedure, as this adverse event is relatively rare. This manuscript may help in the selection of patients undergoing EUS-FNA, and clarifies the points we should be careful about after the procedure.
