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

  • Luca Giovanni Campana Veneto Institute of Oncology (IOV-IRCCS), Padova
  • Marco Scarpa Veneto Institute of Oncology (IOV-IRCCS), Padova
  • Antonio Sommariva Veneto Institute of Oncology (IOV-IRCCS), Padova
  • Elena Bonandini University of Padova, Padova
  • Sara Valpione Veneto Institute of Oncology (IOV-IRCCS), Padova
  • Leonardo Sartore University of Padova, Padova
  • Carlo Riccardo Rossi Veneto Institute of Oncology (IOV-IRCCS), Padova

Abstract

Purpose 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 electrtic pulses, as an alternative approach.

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 continous 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 msec-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 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.

Author Biographies

Luca Giovanni Campana, Veneto Institute of Oncology (IOV-IRCCS), Padova
Sarcoma and Melanoma Unit
Marco Scarpa, Veneto Institute of Oncology (IOV-IRCCS), Padova
Surgical Oncology Unit
Antonio Sommariva, Veneto Institute of Oncology (IOV-IRCCS), Padova
Sarcoma and Melanoma Unit
Elena Bonandini, University of Padova, Padova
Department of Pathology
Sara Valpione, Veneto Institute of Oncology (IOV-IRCCS), Padova
Melanoma Unit
Leonardo Sartore, University of Padova, Padova
Plastic Surgery Unit
Carlo Riccardo Rossi, Veneto Institute of Oncology (IOV-IRCCS), Padova
Sarcoma and Melanoma Unit
Published
2013-10-23
How to Cite
Campana, L. G., Scarpa, M., Sommariva, A., Bonandini, E., Valpione, S., Sartore, L., & Rossi, C. R. (2013). Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy. Radiology and Oncology, 47(4). Retrieved from https://radioloncol.com/index.php/ro/article/view/1907
Section
Clinical oncology