Umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer: a true port-site metastasis?

We present a case of umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer. A 59-year-old woman with stage IIIB cervical adenocarcinoma underwent laparoscopic paraaortic lymphadenectomy as well as a conventional laparoscopy to assess the presence of p...

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Bibliographic Details
Published in:Gynecologic oncology 2005-04, Vol.97 (1), p.292-295
Main Authors: Martínez-Palones, José M., Gil-Moreno, Antonio, Pérez-Benavente, María A., Garcia-Giménez, A., Xercavins, Jordi
Format: Article
Language:English
Subjects:
Abdominal Neoplasms - secondary
Adenocarcinoma - pathology
Adenocarcinoma - secondary
Adenocarcinoma - surgery
Angiogenesis
Cervical carcinoma
Female
Humans
Laparoscopy - adverse effects
Lymph Node Excision - adverse effects
Lymph Nodes - pathology
Lymph Nodes - surgery
Lymphatic Metastasis
Middle Aged
Neoplasm Seeding
Paraaortic lymphadenectomy
Port-site metastasis
Retroperitoneal laparoscopy
Retroperitoneal Space
Umbilicus - pathology
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - surgery
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Summary:We present a case of umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer. A 59-year-old woman with stage IIIB cervical adenocarcinoma underwent laparoscopic paraaortic lymphadenectomy as well as a conventional laparoscopy to assess the presence of peritoneal carcinomatosis. The pathologic examination revealed metastasis in one paraaortic node. Peritoneal cytology proved negative for malignant cells. Seven months after completion of chemoradiotherapy, the patient presented a 2.5-cm umbilical tumor involving the trocar tract together with recurrence of the cervical mass. Histological examination of the excised umbilical mass showed recurrence of the cervical adenocarcinoma, with strong peritumoral CD31 immunocytochemical expression. The peritumoral increase in microvessel density and strong CD31 positivity suggests angiogenesis as a potential factor lead to seeding of tumor cells at the umbilical port.
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2004.11.056