早期子宮体癌に対する腹腔鏡下子宮全摘出術後に孤発性のポート部再発をきたした１症例

抄録

　Port-site metastasis (PSM) is specific and challenging complication that occurs after laparoscopic surgery for malignant tumor. Few cases of isolated PSM in patients with early-stage endometrial cancer have been reported; the management and prognosis in this patient population is poorly understood.

　This report presents the case of a 64-year-old woman preoperatively diagnosed with stage IA endometrial cancer (endometrial carcinoma, G1), who performed total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Gross peritoneal dissemination was not observed in the abdominal cavity, and the postoperative pathological diagnosis was stage IA endometrial cancer (serous carcinoma). Cytodiagnosis of the ascites was positive. The patient underwent six courses of paclitaxel and carboplatin chemotherapy postoperatively. At 25 months postoperatively, she complained of a solid mass in her abdominal wall, and CT showed a 20-mm tumor under the skin at the 5-mm port site in the right lower quadrant of the abdomen. A partial abdominal wall resection involving the tumor and surrounding tissue was performed, and the tumor was completely removed. The pathological diagnosis was serous carcinoma, and the tumor was diagnosed as PSM. The patient preferred close monitoring instead of additional adjuvant chemotherapy. No recurrence was detected within 82 months from the initial surgery and 57 months from the PSM.

　PSM of early-stage endometrial cancer is extremely rare, but not reached zero. Surgeons should take care to prevent PSM. Several causative factors of PSM and preventative methods were　retrospectively considered in this patient.