A case report of wound site seeding following cholecystectomy for dysplastic gallbladder. (2017)

• Record Type: Journal Article
• Authors: Ng, Y. Annalisa; Tan, Qing Ting; Wan, Wei Keat; Goh, Yaw Chong
• Is Part Of: International journal of surgery case reports. Volume 35(2017)
• Page Start: 87
• Page End: 93
• Publication Date: 2017
• Subjects: Gallbladder dysplasia -- Malignant transformation -- Tumour seeding -- Wound implantation -- Port site implantation; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2017.04.006
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Wound or port site metastasis is an uncommon complication following laparoscopic oncologic surgery. Unusual case of malignant transformation of implanted dysplastic gallbladder tissue following cholecystectomy. Discussion of risk factors for wound or port site metastasis and how to reduce them. Role of PET-CT in the management of wound or port site metastasis. Surgical treatment of implanted wound or port site tumours. Abstract: Wound site metastasis following cholecystectomy is an uncommon but well recognised complication following laparoscopic surgery for unsuspected gallbladder carcinoma. We describe a case of implantation of dysplastic cells with subsequent malignant transformation at the incision site 3 years post-cholecystectomy for an inflamed gallbladder. Histopathological examination of this tumour confirmed adenocarcinoma of pancreatobiliary origin, possibly secondary to gallbladder cells implantation and subsequent carcinomatous change. Unlike previously reported cases, the present case has two unique features: Firstly, the histology of the resected gallbladder at the initial operation was that of a low-grade dysplasia and not carcinoma; and secondly, there was a long interval between initial surgery and subsequent development of the wound site tumour. This case highlights that careful handling of the specimen tissue intraoperatively is paramount as cells implanted in the wound site can survive and undergo malignant transformation. All new masses occurring along the surgical wound site should be followed up and investigated to exclude implanted tumours.