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Case Reports
. 2015 Jul 21;21(27):8458-61.
doi: 10.3748/wjg.v21.i27.8458.

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

Akiko Tomonari  1 , Akio Katanuma  1 , Tomoaki Matsumori  1 , Hajime Yamazaki  1 , Itsuki Sano  1 , Ryuki Minami  1 , Manabu Sen-yo  1 , Satoshi Ikarashi  1 , Toshifumi Kin  1 , Kei Yane  1 , Kuniyuki Takahashi  1 , Toshiya Shinohara  1 , Hiroyuki Maguchi  1
Affiliations
Case Reports

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

Akiko Tomonari et al. World J Gastroenterol. .

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.

Keywords: Endoscopic ultrasonography-guided fine needle aspiration; Pancreatic cancer; Tumor seeding.

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Figures

Figure 1
Figure 1
Computed tomography showing a 20-mm mass lesion in the pancreatic body (arrow).
Figure 2
Figure 2
Endoscopic ultrasonography-guided fine needle aspiration of the 20-mm hypoechoic mass lesion was performed using a 22-G needle.
Figure 3
Figure 3
Submucosal tumor at the gastric body increased in size at 28 mo after surgery.
Figure 4
Figure 4
Computed tomography shows the submucosal tumor located adjacent to the pancreatic resection site.
Figure 5
Figure 5
Resected specimen of the needle tract seeding in the stomach. The tumor is 25 mm × 25 mm, with a whitish appearance (A). The tumor is located in the submucosal layer (B). Hematoxylin and eosin staining.
See this image and copyright information in PMC

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