# Gastrostomy tract metastasis presenting as a large abdominal wall mass following percutaneous endoscopic gastrostomy for esophageal squamous cell carcinoma: a case report

## TL;DR

A rare case of cancer spreading through a gastrostomy tract after a common feeding tube procedure is reported, with surgical removal of the tumor and abdominal wall repair.

## Contribution

This case report highlights a rare complication of PEG tube placement and describes a successful surgical intervention.

## Key findings

- Gastrostomy tract metastasis presented as a large abdominal wall mass following PEG placement.
- En bloc resection of the mass and PEG tube was performed, followed by successful abdominal wall repair.
- The case emphasizes the need for awareness of this rare complication in cancer patients.

## Abstract

Percutaneous endoscopic gastrostomy (PEG) is a standard method for providing enteral access in patients with obstructive aerodigestive cancer. However, gastrostomy tract metastasis is a rare but devastating complication in patient with aerodigestive cancers who have undergone PEG tube placement. Due to its rarity, the standard therapeutic approach remains undefined. We report the case of an 83-year-old male who developed gastrostomy tract metastasis following pull-type PEG tube placement, presenting as a large abdominal wall mass detected during surveillance following definite chemoradiation for locally advanced thoracic esophageal squamous cell carcinoma. The patient underwent en bloc resection of the abdominal wall mass along with the PEG tube. The abdominal wall defect was closed using an inter-layer polyglactin mesh repair, followed by delayed split-thickness skin grafting.