Port site recurrence, an unintended consequence of laparoscopic resection of ovarian cancer. A case report

BACKGROUND: Cancer surgery has as its goal complete clearance and absolute containment of the malignant disease as it is being resected. Any aspect of the procedure which allows the escapes of malignant cells may result in disease recurrence. METHODS: The patient presented to an emergency room with left-sided abdominal pain. Pelvic sonogram suggested the diagnosis of a ruptured left ovarian cyst. A uterine biopsy showed high grade serous carcinoma. Definitive treatment of the primary ovarian cancer wasen bloc laparoscopic resection of her uterus, Fallopian tube and ovaries. RESULTS: CT showed port site recurrence in both right and left upper abdominal trochar sites. The right-sided port site recurrence was through the fascia just lateral to the right rectus muscle and was small. A much larger port site metastases was present at the right trochar site that was through the left rectus muscle. CONCLUSION: The incidence of midline and lateral port site recurrence after laparoscopy for diagnosis or resection of ovarian cancer has not been determined. Limitation of trochar sites to the midline may reduce the extent of abdominal wall disease spread.