Port-site metastasis: tip of the iceberg?

In 1870 Reincke reported two cases in which tumors developed at the sites of paracentesis for ascites due to peritoneal carcinomatosis. History was repeated in a different context when two cases of port-site metastasis were reported in 1993. In the last 200 years tumor spread has remained a difficult phenomenon to understand, and minimal access surgery has added several more questions. Port-site metastasis has gained the attention of not only minimally invasive surgeons but also the media. Performing an operation for a benign condition is quite different from performing one for a malignant condition. Patients suffering from the latter may not value the advantages of minimal access surgery if there is an increased risk of tumor spread and less of a likelihood for cure.