Endoscopic tattooing: a risk for tumor implantation.
BACKGROUND
Endoscopic tattooing is considered to be a safe procedure to mark a lesion for subsequent surgical resection, and the reported complications are relatively minor. However, here the present case shows tumor traveling through needle tract with tumor inoculation following endoscopic tattooing.


METHODS AND RESULTS
A 68-year-old female who had a clinical stage I rectal cancer underwent laparoscopic rectal low anterior resection. The pathologic examination of the surgical specimen showed a pathologic stage pT1 invasive adenocarcinoma with a 3-mm focus of tumor cells traveling through a transmural tract and a 0.5-mm tumor inoculation in the peri-colonic fat tissue. These two foci of tumor cells were mixed with pigmented substance convincing its association with the endoscopic tattooing.


CONCLUTION
This present case raises the awareness of a severe complication as tumor inoculation by inappropriate endoscopic tattooing which may cause tumor stage upgrading and tumor spreading.
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D050154:Adiposity D000368:Aged D003113:Colonoscopy D005260:Female D006801:Humans D009339:Needles D012004:Rectal Neoplasms D012307:Risk Factors
Endoscopic tattooing Tumor implantation Complication