Abdominal wall vaccination metastasis following percutaneous endoscopic gastrostomy

Background: Percutaneous endoscopic gastrostomy (PEG) meanwhile has become an accepted and routinely used alternative to surgical gastrostomy or nasogastric feeding tubes in patients requiring long-term nutritional support. Major complications are rare. In this paper, we report on a patient with a vaccination metastasis following PEG insertion. Case Report: The patient had advanced squamous cell carcinoma of the esophagus. A fast-growing metastasis was found at the site of PEG insertion - without distant metastasis or local tumor progress. It can be supposed that there was a mechanical transport of tumor cells to the cut by the PEG catheter during PEG insertion. This abdominal wall metastasis was treated with radiotherapy alone, without surgery. The patient is still alive 9 months after the first sign of wall metastasis. Conclusion: We demonstrated that radiotherapy alone is an effective, safe, and well tolerated treatment. Abdominal wall metastases do not necessarily require surgery.