TITLE:
Port-Site Metastasis after Laparoscopic Surgery with Rapid Second Recurrence in Early Stage Endometrial Carcinoma: A Case Report and Review of the Literature
AUTHORS:
Zoulikha Outaggarts, Sarah Johnstone, Annekathryn Goodman
KEYWORDS:
Port Site Metastases, Laparoscopic Hysterectomy, Endometrial Cancer
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.6,
June
17,
2015
ABSTRACT: Introduction: Port site metastases have been
reported with laparoscopic surgery. The mechanism of action is unknown.
Theories include tumor tracking, spillage, pneumoperitoneum, and immune factors.
Methods: We report on a case of aggressive port site metastases and
intra-abdominal recurrence after an uncomplicated laparoscopic hysterectomy for
a grade 2, minimally invasive endometrioid adenocarcinoma of the uterus. The
world literature on port site metastases in gynecological cancer is reviewed. Results: Port site metastases have two distinct
presentations. In the first pattern, the
metastases are isolated to the laparoscopic port sites. In the second pattern,
port site metastases are associated with widespread intra-abdominal recurrence.
Conclusion: Port site metastases are rare but occur with laparoscopic surgery.
Meticulous attention to surgical technique including the use of specimen bags
to isolate tissue and prevent spillage should be performed. Data registries
should be instituted to track the incidence and outcomes of port site
metastases.