Resected tumor seeding in stomach wall due to endoscopic ultrasonography-guided fine needle aspiration of pancreatic adenocarcinoma |
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Authors: | Akiko Tomonari Akio Katanuma Tomoaki Matsumori Hajime Yamazaki Itsuki Sano Ryuki Minami Manabu Sen-yo Satoshi Ikarashi Toshifumi Kin Kei Yane Kuniyuki Takahashi Toshiya Shinohara Hiroyuki Maguchi |
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Institution: | 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 |
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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. |
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Keywords: | Endoscopic ultrasonography-guided fine needle aspiration Tumor seeding Pancreatic cancer |
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