<abstract xmlns="http://www.w3.org/1999/xhtml"> Background. Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the gold standard in most patients. We describe electrochemotherapy (ECT), a minimally invasive method for locally-enhancing drug delivery by means of electric pulses, as an alternative approach. Patient and methods. A 49-year-old man with advanced gastric cancer developed skin metastases around an ileostomy site. The ulcerated and oozing tumor growth impaired patient’s quality of life due to continuous trouble in fitting the ostomy appliance, its poor adherence and consequent stools spillage. ECT consisted of a 20-minute course under mild general sedation. A bleomycin bolus of 15 000 IU/m2 was followed by the percutaneous application of multiple, 1.5 ms -long electric pulses by means of a needle electrode. Results. Post ECT course was uneventful and the patient was discharged on the same day. After one week, tumor nodules were flattened and partial tumor regression was appreciable at one-month follow-up. More importantly, peristomal skin conditions significantly improved, thus allowing for an effective application of the ostomy appliance during the following moths, until patient’s death. Conclusions. This report suggests the feasibility of ECT as a minimally invasive approach for peristomal tumors. In selected cases, ECT, by achieving a rapid tumor control, may ensure effective ostomy management and preserve patients’ quality of life.</abstract>

Background. Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the gold standard in most patients. We describe electrochemotherapy (ECT), a minimally invasive method for locally-enhancing drug delivery by means of electric pulses, as an alternative approach. Patient and methods. A 49-year-old man with advanced gastric cancer developed skin metastases around an ileostomy site. The ulcerated and oozing tumor growth impaired patient’s quality of life due to continuous trouble in fitting the ostomy appliance, its poor adherence and consequent stools spillage. ECT consisted of a 20-minute course under mild general sedation. A bleomycin bolus of 15 000 IU/m2 was followed by the percutaneous application of multiple, 1.5 ms -long electric pulses by means of a needle electrode. Results. Post ECT course was uneventful and the patient was discharged on the same day. After one week, tumor nodules were flattened and partial tumor regression was appreciable at one-month follow-up. More importantly, peristomal skin conditions significantly improved, thus allowing for an effective application of the ostomy appliance during the following moths, until patient’s death. Conclusions. This report suggests the feasibility of ECT as a minimally invasive approach for peristomal tumors. In selected cases, ECT, by achieving a rapid tumor control, may ensure effective ostomy management and preserve patients’ quality of life.

Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy

Sarcoma and Melanoma Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy

Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy

Department of Pathology, University of Padova, Padova, Italy

Melanoma Cancer Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy

Plastic Surgery Unit, University of Padova, Padova, Italy

Radiology and Oncology

Background. Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the...

Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy

Published Online: Oct 08, 2013

Page range: 370 - 375

DOI: https://doi.org/10.2478/raon-2013-0051

Keywords
stomach neoplasms, ileostomy, electrochemotherapy, skin care, palliative care

This content is open access.

Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy

Published Online: Oct 08, 2013

Page range: 370 - 375

DOI: https://doi.org/10.2478/raon-2013-0051

Keywordsstomach neoplasms, ileostomy, electrochemotherapy, skin care, palliative care

This content is open access.

Keywords
stomach neoplasms, ileostomy, electrochemotherapy, skin care, palliative care