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Clinical Journal of Gastroenterology

, Volume 11, Issue 3, pp 200–205 | Cite as

Postoperative recurrence from tract seeding after use of EUS–FNA for preoperative diagnosis of cancer in pancreatic tail

  • Utae Sakamoto
  • Nobuhiko Fukuba
  • Shunji Ishihara
  • Shohei Sumi
  • Mayumi Okada
  • Hiroki Sonoyama
  • Naoki Ohshima
  • Ichiro Moriyama
  • Kousaku Kawashima
  • Yoshikazu Kinoshita
Case Report

Abstract

A 50-year-old male underwent abdominal computed tomography at a city hospital in Japan, which revealed a tumor 38 mm in diameter in the tail of the pancreas. Based on findings from endoscopic ultrasonography-guided fine needle aspiration using a 22-gauge needle with a side hole, the tumor was diagnosed as an invasive ductal carcinoma. The patient was referred to our hospital and underwent a distal pancreatectomy. Esophagogastroduodenoscopy performed as part of a medical checkup at another hospital 2 years later revealed a 20-mm-sized submucosal tumor in the posterior wall of the upper body of the stomach. Examination of a biopsy specimen obtained from the top of the lesion revealed adenocarcinoma. Partial resection of the stomach was performed and pathological findings showed an adenocarcinoma in all layers of the stomach wall, consistent with recurrence derived from needle tract seeding of the previously excised cancerous tumor from the pancreatic tail. Additional experimentation performed for confirmation with an agar model showed that agar on the deep side leaked to the shallow side following puncture with a needle with a side hole used with a slow-pull technique.

Keywords

Pancreatic cancer EUS-FNA Recurrence Tracle seeding 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human/animal rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from the patient for being included in the study.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Utae Sakamoto
    • 1
  • Nobuhiko Fukuba
    • 1
    • 3
  • Shunji Ishihara
    • 1
  • Shohei Sumi
    • 1
  • Mayumi Okada
    • 1
  • Hiroki Sonoyama
    • 1
  • Naoki Ohshima
    • 1
  • Ichiro Moriyama
    • 2
  • Kousaku Kawashima
    • 1
  • Yoshikazu Kinoshita
    • 1
  1. 1.Department of Internal Medicine IIShimane University Faculty of MedicineIzumoJapan
  2. 2.Division of Cancer CenterShimane University HospitalIzumoJapan
  3. 3.Department of Internal MedicineIzumo City General Medical CenterIzumoJapan

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