PakMediNet Discussion Forum : Surgery : trocar site metastasis
trocar site metastasis
a middle aged male had laporoscopic cholecystectomy. The histology of the gall bladder specimen was reported as benign with no evidence of malignancy. 8 Months later he presented with a hard mass at the site of umblicard port. This needed surgical excision with wide area of surrounding area.The histology of the excised mass at the umblical port was reported as adenocarcinoma. CT POST OP did not reveal any evidence of any tumour in the pancreas or metastasis any where else.
He did develop incisional hernia at the site of umblical port after excision of the mass.
The most likely cause of port site metastasis is primary adenocarcinoma of the gall bladder which was missed initially at the submission of laparoscopic cholecystectomy specimen.
Posted by: oonwalaPosts: 2 :: 09-09-2002 :: | Reply to this Message
Re: trocar site metastasis
Dear sir
Gallbladder ca is extremely rare. Do you use re-usable trochars?
Could there have been cross contamination of malignant cells?
Have you re-checked the original gallbladder specimen and the histology?
Has the patient been kept under review since the diagnosis?
Maybe Im being a little harsh, but it is an extremely rare and interesting case and all potential avenues should be explored as to the cause of the port hole metastasis before blaming the poor pathologist!!!
Zahid Raza
Consultant Vascular Surgeon
Royal Infirmary Edinburgh
Posted by: zrazaPosts: 3 :: 23-09-2002 :: | Reply to this Message
Re: trocar site metastasisdid you rule out ovarian /stomach as primary
Posted by: nahmedPosts: 5 :: 24-08-2003 :: | Reply to this Message