Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 10, 2016; 7(2): 270-274
Published online Apr 10, 2016. doi: 10.5306/wjco.v7.i2.270
Isolated subcutaneous implantation of a borderline ovarian tumor: A case report and review of the literature
Malgorzata Banys-Paluchowski, Borsu Yeganeh, Jutta Luettges, Achim Maibach, Ruediger Langenberg, Natalia Krawczyk, Peter Paluchowski, Holger Maul, Gerhard Gebauer
Malgorzata Banys-Paluchowski, Borsu Yeganeh, Ruediger Langenberg, Holger Maul, Gerhard Gebauer, Department of Obstetrics and Gynecology, Marienkrankenhaus Hamburg, 22087 Hamburg, Germany
Jutta Luettges, Achim Maibach, Department of Pathology, Marienkrankenhaus Hamburg, 22087 Hamburg, Germany
Natalia Krawczyk, Department of Obstetrics and Gynecology, University Hospital Duesseldorf, 40225 Duesseldorf, Germany
Peter Paluchowski, Department of Obstetrics and Gynecology, Regio Klinik Pinneberg, 25421 Pinneberg, Germany
Author contributions: Banys-Paluchowski M and Yeganeh B designed the report; Luettges J and Maibach A performed the histopathological analyses; Langenberg R and Maul H collected the patient’s clinical data; Banys-Paluchowski M, Krawczyk N, Paluchowski P and Gebauer G analyzed the data and wrote the paper.
Institutional review board statement: The article has been approved for publication by the Institutional Review Board of the Marienkrankenhaus Hamburg, Germany.
Informed consent statement: The patient provided informed written consent prior to publication.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Malgorzata Banys-Paluchowski, MD, MED, Department of Obstetrics and Gynecology, Marienkrankenhaus Hamburg, Alfredstr. 9, 22087 Hamburg, Germany. maggybanys@yahoo.de
Telephone: +49-40-25461603 Fax: +49-40-25461619
Received: August 22, 2015
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
Abstract

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.

Keywords: Laparoscopy, Subcutaneous metastasis, Tumor implantation, Borderline tumor of the ovary

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.