Port-Site Metastasis of Undiagnosed Pancreatic Adenocarcinoma After Laparoscopic Radical Prostatectomy: Case Report and Literature Review

Pinho, Gotardo Zini; Bechara, Gustavo Ruschi; Posses, Samira Pereira das; Carli, Claudio De; Miranda, Marcelo Cabral Lamy de

doi:10.1089/cren.2018.0046

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…A systematic review of port site metastases after robot-assisted surgery revealed histological variance in cases involving surgical device seeding, such as cervical squamous cell carcinoma and adenocarcinomas, gallbladder carcinoma, and urothelial cell carcinoma [11] . Additional primaries associated with port site metastases and seeding events after robot-assisted surgery have been described for renal cell carcinoma, prostate adenocarcinoma, and endometrial carcinoma [4] , [5] , [6] , [7] , [8] , [9] , [13] , [14] .…”

Section: Discussionmentioning

confidence: 99%

“…Ikeuchi et al reported on a 65-year-old male with Gleason 9 (5+4) prostate adenocarcinoma who underwent RALP and found to be pT3bN0 with positive margins who developed local recurrence and port site and lymph node metastases 18-weeks postoperatively [6] . Pinho et al reported on a 65-year-old male with Gleason 8 (4+4) prostate adenocarcinoma (pT2c) with positive lateral margin after RALP and elevated postoperative PSA of 0.3 ng/mL 6 weeks postoperatively who underwent adjuvant radiation therapy who developed an elevated PSA associated with a right anterolateral abdominal wall lesion [8] . Lastly, Jundt et al reported on a 62-year-old male with Gleason 7 (4+3) prostate adenocarcinoma (pT2a) who developed PSA recurrence five years after undergoing RALP with 11C-choline PET/CT demonstrating avidity in the soft tissue associated with a prior laparoscopic site [9] .…”

Section: Discussionmentioning

confidence: 99%

“…Case reports described port site and peritoneal seeding after laparoscopic and/or RALP with prostate adenocarcinoma and an undiagnosed case of pancreatic adenocarcinoma. [4] , [5] , [6] , [7] , [8] , [9] However, we present a case report of an unusual peritoneal and port site seeding by an undiagnosed urothelial carcinoma of the bladder after RALP for localized prostate cancer.…”

Section: Introductionmentioning

confidence: 90%

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Peritoneal and port site seeding of an undiagnosed urothelial carcinoma of the bladder after robot-assisted laparoscopic prostatectomy

Thibodeau

Nsouli

et al. 2020

Radiology Case Reports

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Laparoscopic prostatectomy and robot-assisted laparoscopic prostatectomy are common procedure performed for the treatment of localized prostate cancer. Port site and peritoneal seeding is an exceedingly rare but known complications associated with this procedure. We present a case of a 71-year old male with low-intermediate risk prostate adenocarcinoma who underwent a robot-assisted laparoscopic prostatectomy. Pathology at that time was negative for extraprostatic extension, seminal vesicle invasion, or margins. Seven months later, the patient presented with gross hematuria and was found to have multiple superficial tumors of the bladder urothelium consistent with high-grade papillary urothelial carcinoma. He then began to experience increasing lower abdominal pain and a palpable, right anterior abdominal mass. Computed tomography-guided biopsy revealed high-grade papillary urothelial carcinoma which strongly suggests peritoneal seeding from his recent robot-assisted laparoscopic prostatectomy. Despite its rarity, the morbidity associated with this phenomenon could help justify a recommendation of careful pathologic examination of each prostate specimen for a second urothelial primary with subsequent cystoscopy if one is found.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

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Peritoneal and port site seeding of an undiagnosed urothelial carcinoma of the bladder after robot-assisted laparoscopic prostatectomy

Thibodeau

Nsouli

et al. 2020

Radiology Case Reports

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“…The implantation and metastasis of the laparoscopic port-site after laparoscopic surgery is based on the premise that there is a malignant tumor in the abdominal cavity. Direct implantation, contamination of surgical instruments, aerosolization of tumor cells, chimney effect, excessive manipulation of tumor, pneumoperitoneum, hematogenous spread, local and systemic effects of carbon dioxide and decrease of abdominal blood flow caused of port-site could lead metastasis through laparoscopic port-site [4] , [5] , [6] , [7] , [8] .…”

Section: Introductionmentioning

confidence: 99%

Metastasis of missed cholangiocarcinoma in the left lobe through abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: Case report and literature review

Huang¹,

Li²,

Chen³

et al. 2021

Radiology Case Reports

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Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, the missed diagnosis of intraperitoneal malignant tumor may occur. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to abdominal cavity or wall, to more extreme condition, will be located in the navel, which is known as Sister Mary Joseph's nodule(SMJN). A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that most of tumor markers were increased. CT revealed a progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and nodular lesions were found under the costal margin of the right side of abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed middle differentiated adenocarcinoma. In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all organs in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

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“…The implantation and metastasis of the laparoscopic port-site after laparoscopic surgery is based on the premise that there is a malignant tumor in the abdominal cavity. Direct implantation, contamination of surgical instruments, aerosolization of tumor cells, chimney effect, excessive manipulation of tumor, pneumoperitoneum, hematogenous spread, local and systemic effects of carbon dioxide and decrease of abdominal blood ow caused of port-site could lead metastasis through laparoscopic port-site [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

Huang

Jiang

et al. 2020

Preprint

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Introduction: Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, a serious but rare condition may be happened, which is the missed diagnosis of intraperitoneal malignant tumor. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to the abdominal cavity or the abdominal wall. The missed laparoscopic malignant tumors are prone to metastasis, especially at the laparoscopic port-site. More extreme condition will be located in the navel, which is known as Sister Mary Joseph’s nodule(SMJN).Case presentation: A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that the most of tumor markers were increased. CT scan revealed that there was a diffused irregular and progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and multiple nodular lesions were found under the costal margin of the right upper abdominal wall, right lower abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed an infiltrative or metastatic middle differentiated adenocarcinoma. So the diagnosis was left lobe cholangiocarcinoma of the liver, multiple lymph nodes metastasis in the abdominal cavity and multiple implant metastasis in abdominal wall laparoscopic port-site and umbilical.Conclusion: In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, like gallstone in biliary system, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor or other lesions. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all the organs and tissues in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

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Port-Site Metastasis of Undiagnosed Pancreatic Adenocarcinoma After Laparoscopic Radical Prostatectomy: Case Report and Literature Review

Cited by 4 publications

References 7 publications

Peritoneal and port site seeding of an undiagnosed urothelial carcinoma of the bladder after robot-assisted laparoscopic prostatectomy

Peritoneal and port site seeding of an undiagnosed urothelial carcinoma of the bladder after robot-assisted laparoscopic prostatectomy

Metastasis of missed cholangiocarcinoma in the left lobe through abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: Case report and literature review

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

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