Isolated port site recurrence of node-negative clinical stage IB1 cervical adenocarcinoma

Abstract

IntroductionPort site metastasis after laparoscopic surgery for cervical cancer is a rare phenomenon.MethodsWe present a case report of isolated port site recurrence 4 years following laparoscopic surgery in a patient with node-negative, clinical stage IB1 cervical adenocarcinoma.ResultsA 44 year-old woman presented with a necrotic cervical lesion. A biopsy of the mass revealed invasive endocervical adenocarcinoma. She underwent a robotic-assisted radical hysterectomy, bilateral salpingectomy, and pelvic lymph node dissection with bilateral oophoropexy. All lymph nodes were placed in an Endocatch bag prior to removal via the 12 mm assistant port. There was no clinical evidence of metastatic disease and final pathology revealed negative surgical margins and lymph nodes. Four years later, she re-presented with a soft tissue mass in her abdominal wall underlying the site of the prior laparoscopic assistant port. This was confirmed by transcutaneous biopsy to be metastatic adenocarcinoma of endocervical origin. Further work-up revealed no other evidence of metastatic disease. The recurrence was excised and all margins were negative.ConclusionThis is the first case report describing an isolated port site recurrence in a patient who underwent robotic-assisted laparoscopic surgery for early-stage cervical adenocarcinoma with negative margins and negative lymph nodes. The mechanism underlying this isolated recurrence remains unknown.

CA Cervix metastasising to the abdominal wall – A rare case report

“…This study concluded that these patients should be closely monitored for recurrent disease with continued vigilance and long-term follow-up, including persistent attention to and thorough examination of port-sites at each outpatient visit. (5) The case reported here is a very rare, as the abdominal wall metastasis specially in between the rectus muscle and peritoneum developed after treatment, with no evidence of associated loco-regional or distant metastasis at any other site. Ramirez et al showed that in a median follow-up period of 12 months, 63% of patients died of disease (6) .…”

Intestinal metastasis after total laparoscopic radical trachelectomy for stage IB1 cervical cancer: A case report

“…Given that more women in this subgroup required adjuvant therapy, which may consequently reduce fertility, and current studies are limited by both sample size and follow-up, further studies are needed before trachelectomy can be considered a safe treatment option for women with tumors ≥2 cm (Pareja et al, 2015). In addition to considering the tumor size, patients with G3 tumors and adenosquamous or adenocarcinoma should be informed that grading and histologic type are risk factors for prognosis (Barlin et al, 2013; Kong et al, 2016; Belval et al, 2006; Kim et al, 2013; Deshmukh et al, 2017; Mangler et al, 2014).…”

Port-Site Metastasis in Gynecological Malignancies

“…15 Our group published the first report of isolated PSM occurring 4 years after roboticassisted laparoscopic surgery in a patient with early stage, node-negative cervical adenocarcinoma. 7 Our aim in this review is to shed some light on the likely mechanism of PSM, risk factors, and preventive measures as well as propose management strategies and summarize the impact on the oncological outcomes of patients, who experience this rare complication.…”

“…5,6 Here, we present a case report of an isolated PSM occurring after robotic-assisted laparoscopic surgery in a patient with early stage, node-negative cervical adenocarcinoma and provide review of recent literature on management as well as oncologic outcomes of PSM. 7…”