Drain or not drain? A surgical dilemma using suction drain for drain site metastasis in a patient with uterine sarcoma

Abstract

Drain placement is a common practice after major surgeries to prevent collection accumulation in the operation field, follow up against the risk of bleeding or anastomotic leakage, and facilitate wound healing, especially in patients with large amounts of ascites such as ovarian cancer. Although port site recurrences have been described after laparoscopic surgery, metastasis to the previous drain site rarely occurs after laparotomy in gynecologic cancer patients. Cutaneous involvement originating from uterine sarcoma is particularly unusual. Albeit rare, malignant-cell seeding along an artificial percutaneous tract should be kept in mind when deciding to place a drain. We present a case of uterine undifferentiated sarcoma recurrence at the surgical drain site after one year later of primary tumour resection.