Treatable solitary giant port site metastasis following cholecystectomy for carcinoma gall bladder

Abstract

Patients who are incidentally diagnosed to have carcinoma of the gall bladder following a laparoscopic cholecystectomy are potentially at risk of developing port site metastasis. Port site recurrence is often associated with peritoneal metastases. Here we have presented a case, where a single large port metastasis without peritoneal disease was excised with satisfactory outcomes in terms of surgery, cosmesis and overall survival. A 45-year old lady following a routine laparoscopic cholecystectomy was incidentally diagnosed to have adenocarcinoma of gall bladder (T2). She was then referred to our center where she had a radical cholecystectomy with nodal clearance (N0). Two years later, she presented with a large port site metastasis. PET-CT showed uptake only at the lump and attempt to downsize the tumor with chemotherapy was unsuccessful. Following excision, the 15cm defect in the anterior abdominal wall was reconstructed using a composite mesh. Skin cover was provided using a local rotation 􀏐lap. Fifteen months later, the patient is disease free. Port site excision during de􀏐initive resection is not mandatory as it has not been shown to be associated with improved survival. In this case, due to absence of disease elsewhere, aggressive surgical resection was undertaken for the large port site recurrence.