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Open Access Highly Accessed Open Badges Original research article

Percutaneous endoscopic gastrostomy site metastasis from head and neck squamous cell carcinoma: case series and literature review

Andrew T Huang1*, Alexandros Georgolios1, Sasa Espino2, Brian Kaplan2, James Neifeld3 and Evan R Reiter1

Author Affiliations

1 Department of Otolaryngology – Head and Neck Surgery, Virginia Commonwealth University Massey Cancer Center, Richmond, VA, USA

2 Commonwealth University School of Medicine, Richmond, VA, USA

3 Department of Surgery, Virginia Commonwealth University Massey Cancer Center, Richmond, VA, USA

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Journal of Otolaryngology - Head and Neck Surgery 2013, 42:20  doi:10.1186/1916-0216-42-20

Published: 28 February 2013



To present our experience with head and neck squamous cell carcinoma (HNSCC) seeding of percutaneous endoscopic gastrostomy (PEG) sites and to review all reported cases to identify risk factors and develop strategies for complication avoidance.

Materials and methods

The records of 4 patients with PEG site metastasis from HNSCC were identified from the authors’ institution. Thirty-eight further cases were reviewed following a PubMed search and evaluation of references in pertinent articles.


Review of 42 cases revealed the average time from PEG to diagnosis of metastatic disease to be 8 months. Average time to death from detection of PEG disease was 5.9 months. One-year survival following PEG metastasis was 35.5% with an overall mortality of 87.1%.


PEG site metastatic disease portends a poor prognosis. Early detection and aggressive therapy may provide a chance of cure. Changes in PEG technique or in timing of adjunctive therapies are possible avenues in further research to prevent this complication.

Percutaneous endoscopic gastrostomy; Head and neck cancer; PEG; Metastasis; Prophylactic irradiation