Port site metastatic disease in ovarian carcinoma

Port-site metastases are a recognised complication of laparoscopy in the presence of malignancy. With the increased use of minimally invasive technology to surgically manage gynaecological malignancy, their incidence is likely to increase. We describe three cases where patients underwent laparoscopy prior to referral for definitive surgery.

Patient one attended a secondary centre complaining of urinary incontinence and abdominal pain. Pre-operative imaging identified omental thickening and ascites. Laparoscopy was performed and malignancy of the omentum and peritoneum was identified in addition to a suspicious appearing ovary. The second case concerned a 65 year-old patient presented with abdominal pain and underwent emergent laparoscopy in which adenocarcinoma of the ovary was diagnosed. After biopsies were obtained, the patient was referred for definitive surgical management. Patient three underwent laparoscopy due to abdominal pain. Pre-operative imaging identified ascites and a pelvic mass. Biopsies were taken at laparoscopy which confirmed ovarian malignancy.

All three patients developed histologically proven port-site metastatic disease prior to undergoing definitive surgical management.

In all cases, port-site metastatic disease developed rapidly and was clinically suspected at the time of definitive surgery. We recommend that consideration be given towards removing port sites when performing cytoreductive surgery for gynaecological malignancy.