CT findings in two cases of port-site metastasis after laparoscopy for ovarian cancer

Cases: Two patients with histologically proven port-site metastasis following laparoscopic procedures for ovarian cancer underwent a CT scan. These two patients were initially treated for a stage IA and III ovarian cancer. Port-site recurrence occurred six and 19 weeks following the laparoscopic procedure. In one patient, the abdominal wall recurrence was associated with peritoneal carcinosis. In both patients, CT scan revealed the presence of an heterogeneous nodular lesion inside the left oblique muscle. Histologic analysis confirmed the diagnosis of port-site recurrence.

Conclusions: Port-site metastases could be observed in the treated patients with a laparoscopic approach for ovarian cancer. When this diagnosis is clinically suspected, a CT scan should be performed in order to precise the diagnosis of port-site metastasis and to evaluate potential intra-abdominal recurrent disease. However, only histologic examination can confirm a diagnosis of port-site recurrence.

Laparoscopy; Recurrence; Trocarsite; Ovarian cancer; CT scan

[1] Childers J.M., Keith A. A., Surwit E. A., Hallum A. Y., Hatch K D.: "Abdominal wall tumor implantation after laparoscopy for malignant conditions". Ohstet. Gynecol., 1994, 84, 765.

[2] Kadar N.: "Port-site recurrences following laparoscop1c operations for gynecological malignancies". Br. J. Obstet. Gynecol., 1997, 104, 1308.

[3] Leminen A., Lehtovirta P.: "Spread of ovarian cancer after laparoscopic surgery: report of eight cases". Gynecol. Oncol., 1999, 75, 387.

[4] Morice P., Yiala J., Pautier P., Lhomme C., Duvillard P., Castaigne D.: "Port site metastasis after laparoscopic surgery for gynecological cancer. Report of 6 cases and surgical implications for prevention". J. Reprod. Med., 2000, 45, 837.

[5] Wang P. H., Yuan C. C., Lin G., Ng H. T., Chao H. T.: "Risk factors contributing to early occurrence of port site metastases of laparoscopic surgery for malignancy". Gyneco!. Oneal., 1999, 72, 38.

[6] Tsivian A., Shtabsky A., Issakov J., Gutman M., Sidi A. A., Szold A: "The effect of pneumoperitoneum on dissemination and scar implantalion of intra-abdominal tumor cells". J. Ural., 2000, 164, 2096.

[7] Allardyce R. A.: "Is the port site really at risk? Biology,m echanisms and prevention: a critical view". Aust. N. Z. J. Surg., 1999, 69, 479.