Multiple port-site metastasis of incidental gallbladder carcinoma after laparoscopic cholecystectomy

Raznatovic, Zoran; Zaric, Nemanja; Galun, Danijel; Lekić, Nebojša; Micev, Marjan; Djordjević, Vladimir; Djurasic, Ljubomir; Kerkez, Mirko

doi:10.2298/aci1201105r

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…[14] Razontovic et al, reported a 61-yearold female who presented with PSM post-surgery and died after 2 months. [15] Conversely, Sandor et al, presented a case of PSM of GBC that was treated and followed up 11 months postsurgery with no further complaints. [16] Ninety percent of PSM cases were found in the trocar site, from where the gallbladder specimen was extracted.…”

Section: Discussionmentioning

confidence: 99%

Late port-site metastasis of unexpected gallbladder carcinoma after laparoscopic cholecystectomy: A case report

Aloraini,,

Alshehri,

Alshammari,

et al. 2024

Medicine

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Introduction: Incidental gallbladder carcinoma refers to a discovery of gallbladder cancer during or after cholecystectomy. Late port-site metastasis (PSM) following Laparoscopic cholecystectomy (LC) is rare with an incidence rate of 10.3%. Patient concerns: We report a case of a 58-year-old man who presented with a painful abdominal wall mass for 6 weeks. He had a history of LC for symptomatic cholelithiasis, 8 years prior. Diagnosis: Histopathological examination revealed a positive result for metastatic adenocarcinoma from the abdominal wall mass. Moreover, Positron emission tomography (PET) showed a small focus of intense fluorodeoxyglucose (FDG) uptake in the gallbladder bed, which was highly suspicious for malignancy. Intervention: Decision was to proceed with surgery owing to uptake in the gallbladder bed with single-site metastasis to the previous port site. In addition, in the board meeting, an agreement was reached for performing distal pancreatectomy with splenectomy owing to uncertainty of malignancy based on what was discovered during the full metastatic workup. Diagnostic laparoscopy followed by midline laparotomy performed. Radical completion cholecystectomy with lymphadenectomy was done. Followed by complete resection of the anterior abdominal wall. Distal pancreatectomy and splenectomy were then performed. Outcome: Pathological diagnosis showed metastatic/invasive, moderately differentiated adenocarcinoma with positive margins on the posterior surface of excised port-site mass. The positive margins necessitated further chemoradiotherapy, followed by adjuvant chemotherapy until lung metastasis was identified. After this, the patient was scheduled for palliative chemotherapy. Conclusion: Presence of PSM is often associated with peritoneal metastasis. For this reason, it is advised to evaluate the patient for possible metastasis.

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Section: Discussionmentioning

confidence: 99%

Late port-site metastasis of unexpected gallbladder carcinoma after laparoscopic cholecystectomy: A case report

Aloraini,,

Alshehri,

Alshammari,

et al. 2024

Medicine

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“…Occult GBC is seen on postoperative histopathology in up to 3% of cases undergoing cholecystectomy for benign diseases. [ 3 ] Laparoscopic handling of GBC is associated with the development of PSM, seen in up to 29% of cases. [ 1 , 2 ] Some authors also suggested port-site resection to decrease the development of PSM in incidental GBCs detected postlaparoscopic cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

Delayed Recurrence of Gall Bladder Cancer as Port-site Metastases with Occult Primary Detected on Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography: A Tale of Two Cases

Singh,

Parida,

Bishnoi

et al. 2023

Indian Journal of Nuclear Medicine

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Laparoscopic cholecystectomy is a fairly common procedure and is currently considered the gold standard for cholecystectomy. However, the laparoscopic procedure in the presence of gall bladder cancer (GBC) is associated with the risk of port-site metastasis (PSM). Furthermore, in few cases, GBC remains occult even on postoperative histopathology and presents with PSM remotely. Here, we describe two such cases of GBC with occult primary who presented with PSM and also defined the role of fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography in the management of such cases.

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“…The increase in the number of laparoscopic surgical procedures has led to the discovery of an increased number of incidental gallbladder carcinomas at an early stage [2]. Histopathological examination reveals an incidental carcinoma in approximately 1-2% of patients undergoing laparoscopic cholecystectomy [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not?

Matías‐García

Mendoza‐Moreno

Díez-Alonso

et al. 2021

Case Reports in Surgery

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Introduction. Abdominal wall masses are a common finding in clinical practice. A high percentage of these masses are malignant. We present the case of a patient operated for a gallbladder adenocarcinoma, who consulted eleven years later for a malignant mass of the abdominal wall in synchrony with two adenocarcinomas of the left colon and sigmoid. Case Report. A 75-year-old male underwent a laparoscopic cholecystectomy with an incidental diagnosis of adenocarcinoma in situ (TisN0M0 according to AJCC 8th edition). The operative report mentioned that the removal of the gallbladder was difficult due to the inflammatory process, and the gallbladder was accidentally opened during the operation. It was not clear from the operative report whether an extraction bag was utilized to remove the specimen, but the histopathological study confirmed an open gallbladder. He presented 11 years later with an asymptomatic heterogeneous complex cystic mass involving the anterior rectus abdominis muscle. Colonoscopy showed synchronous tumors in the descending and sigmoid colon with pathology confirming adenocarcinoma. The patient underwent an elective laparotomy with resection of the anterior abdominal wall mass, left hemicolectomy, and sigmoidectomy. The histopathological results of the abdominal mass (CK7, CK20, EMA, CEA positive) were described as metastasis of adenocarcinoma of biliary origin. Discussion. Port site recurrences are rare complications following laparoscopic surgery when malignancy is unsuspected. Possible factors related to local implantation include direct seeding of spilled bile or tumor cells into the wound or shedding of tumor cells due to pneumoperitoneum-induced loss of the peritoneal barrier at the trocar site. In the absence of distant metastasis, treatment should include wide port site excision with malignancy-free surgical margins. Conclusion. Abdominal wall metastasis from gallbladder carcinoma is rare, and its synchronous presentation with a malignant neoplasm of the colon is exceptional. This is the first report of a patient with abdominal wall metastasis from a gallbladder adenocarcinoma operated eleven years ago that debuted synchronously with two adenocarcinomas of the left colon and sigma.

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Multiple port-site metastasis of incidental gallbladder carcinoma after laparoscopic cholecystectomy

Cited by 10 publications

References 15 publications

Late port-site metastasis of unexpected gallbladder carcinoma after laparoscopic cholecystectomy: A case report

Late port-site metastasis of unexpected gallbladder carcinoma after laparoscopic cholecystectomy: A case report

Delayed Recurrence of Gall Bladder Cancer as Port-site Metastases with Occult Primary Detected on Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography: A Tale of Two Cases

Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not?

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