A percutaneous endoscopic gastrostomy (PEG) was placed by the "pull technique" in a 67-year old patient before initiation of palliative radiation therapy of a gastric adenocarcinoma invading the distal esophagus. A tumor metastasis developed in the peristomal area and around the gastrocutaneous fistula tract; it was most likely caused by implantation of tumor tissue adhering to the PEG tube. This complication of PEG placement appears to be very rare.
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