Affordable Access

Access to the full text

Needle tract seeding recurrence of pancreatic cancer in the gastric wall with paragastric lymph node metastasis after endoscopic ultrasound-guided fine needle aspiration followed by pancreatectomy: a case report and literature review

  • Sato, Nami1
  • Takano, Shigetsugu1
  • Yoshitomi, Hideyuki1
  • Furukawa, Katsunori1
  • Takayashiki, Tsukasa1
  • Kuboki, Satoshi1
  • Suzuki, Daisuke1
  • Sakai, Nozomu1
  • Kagawa, Shingo1
  • Mishima, Takashi1
  • Nakadai, Eri1
  • Mikata, Rintaro2
  • Kato, Naoya2
  • Ohtsuka, Masayuki1
  • 1 Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8677, Japan , Chiba (Japan)
  • 2 Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan , Chiba (Japan)
Published Article
BMC Gastroenterology
Springer (Biomed Central Ltd.)
Publication Date
Jan 15, 2020
DOI: 10.1186/s12876-020-1159-x
Springer Nature


BackgroundEndoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has high accuracy and a low complication rate; therefore, it has been widely used as a useful tool for diagnosis of and to determine treatment strategies for pancreatic tumors. Recently, reports of the recurrence of needle tract seeding after EUS-FNA are emerging.Case presentationAn 83-year-old woman was referred to our hospital to undergo further examination of her pancreatic tumor. Multidetector computed tomography (MDCT) revealed a 25-mm-diameter mass in the pancreatic body. She underwent EUS-FNA (transgastric, 22-G needle, 2 passes) and was subsequently diagnosed with adenocarcinoma. Distal pancreatosplenectomy followed by adjuvant chemotherapy with S-1 for 6 months was performed. The level of carbohydrate antigen 19–9 gradually increased 22 months after surgery, and MDCT, which was performed 3 months later, revealed a 23-mm low-density mass in the stomach and paragastric lymph node swelling. Gastroendoscopy revealed a submucosal tumor, and endoscopic ultrasound revealed a hypoechoic mass in the submucosa of the gastric wall. Partial gastrectomy with lymph node resection was performed. The pathological findings showed adenocarcinoma extending from the subserosa to the submucosa and lymph node metastasis, consistent with a tumor recurrence from the resected pancreatic tumor. She received adjuvant chemotherapy with S-1; recurrence was not observed for 5 months, at the time of this writing.ConclusionIt is important to pay careful attention to the development of needle tract seeding in patients with pancreatic cancer diagnosed by EUS-FNA. This is the first case of needle tract seeding with lymph node metastasis, highlighting the need for caution and providing novel insight in the postoperative follow-up of patients with pancreatic body/tail cancer.

Report this publication


Seen <100 times