Port site recurrence and unusual diffuse subcutaneous metastases of unexpected early stage ovarian cancer after laparoscopic surgery: a case report

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  • Fusegi Atsushi
    Department of Obstetrics and Gynecology, JA Toride Medical Center, Japan Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan
  • Oshima Noriko
    Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan
  • Nakasuji Takashi
    Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan
  • Ishikawa Tomonori
    Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan
  • Wakana Kimio
    Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan
  • Yoshiki Naoyuki
    Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan
  • Miyasaka Naoyuki
    Department of Perinatal and Women’s Medicine, Tokyo Medical and Dental University, Japan

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Abstract

<p>Port site recurrence is a rare but well-documented adverse event peculiar to laparoscopic surgery. We report an unusual outcome of unexpected early stage ovarian cancer in which port site recurrence occurred after laparoscopic surgery and was followed by diffuse subcutaneous metastases. A 31-year-old Japanese woman with a large tumor in her abdomen visited our hospital. Because no intratumoral solid component was detected on diagnostic imaging, the tumor was diagnosed as a benign ovarian tumor and the patient underwent left ovarian laparoscopic cystectomy. Contrary to our expectations, however, the ovarian tumor was a mucinous carcinoma. We performed additional surgery, but the tumor recurred in the umbilical area, and multiple subcutaneous metastases later appeared. The curative effect of chemotherapy and radiation was limited. This atypical metastatic distribution of an extremely small amount of cancer might have been caused by the laparoscopic procedure. Protection against tumor cell dissemination is necessary during all forms of laparoscopic surgery.</p>

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