PEG use in patients with squamous cell carcinoma.

I read with great interest the paper by Sousa M. Tumor seeding of the fistula tract should be suspected in patients with a previous history of esophageal or nasopharynx squamous cell carcinoma who have undergone a Percutaneous Endoscopic Gastrostomy (PEG) with a persistent gastrocutaneous fistula. Especially after the use of an OTSC. In fact, the "pull technique" for PEG tube placement should not be used in this context.