Port-site metastasis of unsuspected gallbladder carcinoma with ossification after laparoscopic cholecystectomy: A case report |
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Authors: | Kai-Jun Gao Zhi-Long Yan Yu Yu Liang-Qi Guo Chen Hang Jia-Bin Yang Mou-Cheng Zhang |
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Institution: | Kai-Jun Gao, Liang-Qi Guo, Chen Hang, Jia-Bin Yang, Medical School of Ningbo University, Ningbo University, Ningbo 315211, Zhejiang Province, ChinaZhi-Long Yan, Mou-Cheng Zhang, Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, ChinaYu Yu, Department of Gastrointestinal Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo 315100, Zhejiang Province, China |
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Abstract: | BACKGROUNDUnsuspected gallbladder carcinoma (UGC) refers to cholecystectomy due to benign gallbladder disease, which is pathologically confirmed as gallbladder cancer during or after surgery. Port-site metastasis (PSM) of UGC following laparoscopic cholecystectomy is rare, especially after several years.CASE SUMMARYA 55-year-old man presenting with acute cholecystitis and gallstones was treated by laparoscopic cholecystectomy in July 2008. Histological analysis revealed unexpected papillary adenocarcinoma of the gallbladder with gallstones, which indicated that the tumor had spread to the muscular space (pT1b). Radical resection of gallbladder carcinoma was performed 10 d later. In January 2018, the patient was admitted to our hospital for a mass in the upper abdominal wall after surgery for gallbladder cancer 10 years ago. Laparoscopic exploration and complete resection of the abdominal wall tumor were successfully performed. Pathological diagnosis showed metastatic or invasive, moderately differentiated adenocarcinoma in fibrous tissue with massive ossification. Immuno-histochemistry and medical history were consistent with invasion or metastasis of gallbladder carcinoma. His general condition was well at follow-up of 31 mo. No recurrence was found by ultrasound and epigastric enhanced computed tomography.CONCLUSIONPSM of gallbladder cancer is often accompanied by peritoneal metastasis, which indicates poor prognosis. Once PSM occurs after surgery, laparoscopic exploration is recommended to rule out abdominal metastasis to avoid unnecessary surgery. |
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Keywords: | Port-site metastasis Unsuspected gallbladder carcinoma Heterotopic ossification Laparoscopic cholecystectomy Case report Literature review |
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