Port-Site Metastasis of Mucinous Borderline Ovarian Tumor after Laparoscopy

Abstract

We report a case of port-site metastasis after laparoscopic surgery for borderline mucinous ovarian tumors (mBOTs) without spillage and review the related literature. The patient was a 50-year-old nulligravida who presented with abdominal distension. Magnetic resonance imaging showed a 20 × 10-cm multilocular mass with various signal intensities. The wall and septa of the mass were neither thick nor enhanced. A laparoscopy was performed. An intact left ovarian tumor was observed. The weight of the tumor was 1,540 g. The final diagnosis was stage IA intestinal-type mBOT, so the patient did not undergo adjuvant therapy. Twenty-six months after surgery, the patient presented with a 3 × 5-cm palpable mass on the umbilicus. Biopsy of the mass revealed mucinous adenocarcinoma and computed tomography showed a 3.5 × 4.0-cm mass at the umbilicus without additional metastases. A laparotomy was performed and no metastasis in the peritoneal cavity was observed by gross examination. An umbilical mass resection, hysterectomy, right salpingo-oophorectomy, appendectomy, and partial omentectomy were performed. Hematoxylin and eosin-stained sections of the umbilical mass revealed glands of varying size infiltrating the stroma, immunohistologic staining for cytokeratin 7 was positive, and cytokeratin 20 was negative, but no other metastases were observed. The patient was diagnosed with port-site metastasis and invasive recurrence of mBOT. She underwent six cycles of adjuvant paclitaxel and carboplatin therapy. Large ovarian tumors should be carefully extracted without spillage of the tumor contents to prevent port-site metastasis, despite the low incidence.

Mucinous borderline ovarian tumors with and without Intraepithelial Carcinoma: Differences in clinicopathologic features and fertility results

“…However, the clinical prognoses of these diseases are greatly different. The 5‐year survival rate of MBOTs can reach 90–95%, whereas that of mucinous ovarian cancer is only about 30% . IECA was thought to be the further deterioration of MBOTs, and the presence of microinvasion has been regarded by some investigators as microinvasive carcinoma.…”

“…The 5-year survival rate of MBOTs can reach 90-95%, whereas that of mucinous ovarian cancer is only about 30%. [11][12][13] IECA was thought to be the further deterioration of MBOTs, and the presence of microinvasion has been regarded by some investigators as microinvasive carcinoma. However, IECA has only been formally diagnosed as a precancerous lesion of ovarian cancer in recent years.…”

Laparoscopic Surgery for a 91-year-old Woman with a Huge Solid Adult Granulosa Cell Tumor: A Case Report

“…On the other hand, laparoscopy-related tumor implantations were reported in various gynecological malignancies [10][11][12]. It is not yet clear which mechanisms play a role in laparoscopy-related tumor implantations.…”

Laparoscopic distal pancreatectomy without needle aspiration before resection for giant mucinous cell neoplasms

“…This method enabled the specimen to be removed safely without leakage into the peritoneum. However, port‐site recurrence has been reported after laparoscopic resection for large mucinous ovarian tumors, which have malignant potential, similar to MCN . Therefore, careful aspiration is required when the tumor is removed.…”