A 64-year-old man had a percutaneous endoscopic gastrostomy (PEG) placed prior to radiation treatment of an obstructing T2, N1 squamous cell carcinoma of the base of the tongue. Eleven months later, the patient had no evidence of disease at the primary site, but had increasing granulation-like tissue and leakage at the stoma site. Biopsy showed squamous cell carcinoma. Gastroscopy showed an exophytic mass growing around the stoma site.
Rectus sheath was incised and the underlying rectus muscle around the stoma site was taken. Posterior rectus sheath and peritoneum were incised along the same lines.
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