Published online Apr 10, 2016. doi: 10.5306/wjco.v7.i2.270
Peer-review started: August 26, 2015
First decision: October 13, 2015
Revised: December 6, 2015
Accepted: December 18, 2015
Article in press: December 21, 2015
Published online: April 10, 2016
Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed. We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneous metastasis of a borderline ovarian tumor. The patient received a laparoscopic unilateral adnexectomy for a solid-cystic tumor of the right ovary. Histopathological workup showed a papillary borderline tumor of mucinous type. Nine days later she underwent a hysterectomy, left adnexectomy, appendectomy and omentectomy. Exploration of the peritoneum revealed no intraperitoneal implants. Further exploration showed a non-invasive implant of a borderline tumor in the subcutaneous tissue above the fascia that had no contact to the peritoneum. It is hypothesized that tumor cells may have been implanted during a previous laparoscopy, the most recent of which had been fourteen years prior to her current presentation. Various risk factors for port-site malignancies have been identified. Tumor manipulation and extraction of tumor tissue without a protective bag may contribute to development of trocar-site metastasis.
Core tip: Trocar-site subcutaneous metastasis rarely develops after laparoscopic surgery. Avoidance of over-manipulation of the tumor and use of a protective bag for removal of tumor tissue may minimize the risk of this complication.