J Korean Med Sci.  2017 Nov;32(11):1891-1895. 10.3346/jkms.2017.32.11.1891.

Port-Site Metastasis of Uterine Carcinosarcoma after Laparoscopy

• Tan Z
• Li A
• Chen L
• Xu X
• Fu C

• KMID: 2390321
• DOI: http://doi.org/10.3346/jkms.2017.32.11.1891

Abstract

We report a case of port-site metastasis after laparoscopic surgery for early stage uterine carcinosarcoma (UCS) and review the related literature. A 53-year-old woman with suspected uterine malignance underwent a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy, infra-colic omentectomy, and pelvic lymphadenectomy resulting pathologically in a stage IA UCS. Twelve months later she developed a palpable abdominal-wall mass at the trocar site without other synchronous metastases. A mass resection was performed and it was pathologically diagnosed with port-site metastasis of UCS. When performing surgery for UCS, specimens should be carefully removed in case small pieces of the occult disseminated metastatic tissues are trapped between the outer surface of the trocar sleeve and the abdominal wall incisional canal. Despite the low incidence, a laparotomy might be considered rather than laparoscopy to prevent port-site metastasis and more gynecological oncology clinical practices might be relevant to the management of port-site metastasis.

Keyword

Uterine Carcinosarcoma; Laparoscopy; Port-Site Metastasis

MeSH Terms

Abdominal Wall
Carcinosarcoma*
Female
Humans
Hysterectomy
Incidence
Laparoscopy*
Laparotomy
Lymph Node Excision
Middle Aged
Neoplasm Metastasis*
Surgical Instruments

Figure

• 

  Fig. 1 Contrast enhanced computed tomography scans showed a mass (arrow) in the abdominal wall near the trocar site of right anterior superior iliac spine, with marginal moderate enhancement after contrast administration. (A) Coronal section view. (B) Transverse section view.

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  Fig. 2 PET-CT scans showed new port-site recurrence (arrow) at the right low abdominal wall with high FDG uptakes (SUVmax=12.9) in the operative trocar site. PET-CT = positron emission tomography-computed tomography, FDG = fluorodeoxyglucose, SUVmax = maximum standardized uptake value.

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  Fig.3 Pathological features of the port-site metastatic tumor. (A) Gross tissue measuring 6×3.5×3.5 cm. (B) H & E stained slides showing metastatic squamous cell carcinoma ×40. (C) Immunohistochemical stained slides showing CK5/6 was positive. (D) Immunohistochemical stained slides showing CD10 was positive. H & E = hematoxylin and eosin.

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