Abstract
A 57-year-old man was admitted to our hospital with a diagnosis of metastatic abdominal wall tumor measuring 8×8 cm. Incisional biopsy indicated adenocarcinoma. The patient had undergone laparoscopic cholecystectomy (LC) after endoscopic excision of the papilla of Vater and lithotomy for cholecysto choledocholithiasis in another hospital 3 years and 7 months previously. The patient underwent abdominal wall all-strata abscission of 13×13 cm and reconstruction using the flap of the left fascia lata. Operative findings showed no signs of recurrence of peritoneal dissemination or lymph node metastasis in the hepatic hilum. On macroscopic examination, the tumor existed mainly across the strata of the port site and progressed along the anterior layer of the rectus sheath. Immunohistochemistry was positive for CK7, CA19-9, and CEA and negative for CK20. There were no malignant findings on pathological re-examination of the gallbladder specimen, but the patient was diagnosed with port site recurrence (PSR) of incidental gallbladder carcinoma. He subsequently underwent laparectomy twice for tumor recurrence and died of cancer. Death occurred 7 years and 2 months from the initial laparectomy and 11 years after the LC. Most patients with PSR have a poor prognosis, but long-term survival may be possible with laparectomy in patients without peritoneal dissemination.
