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Organo Oficial de la Sociedad Mexicana de Urología

2009, Number 4

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Rev Mex Urol 2009; 69 (4)

Renal cell carcinoma metastasis at laparoscopic port site

Arroyo-López R, Aragón-Tovar A, López-Verdugo J, Navarrete-García E, Castillo-Chavira G

Language: Spanish
References: 6
Page: 167-169
PDF size: 123.72 Kb.


ABSTRACT

Oncological safety in laparoscopic procedures for malignant tumors has been widely questioned. Port sites have been the main concern due to tumor seeding and consequent metastases, limiting the use of laparoscopy in malignant tumor treatment.
The patient is an 80-year-old woman with a history of 12-year progression of diabetes mellitus treated with glibenclamida. Patient had left radical nephrectomy by hand-assisted laparoscopy, T2NOMO, and histopathological result of Fuhrman nuclear grade 4 clear cell carcinoma. Her present complaints began with an increase of volume at supraumbilical wound level and left iliac fossa, accompanied by asthenia, adynamia and hyporexia. Biopsy of lesion resulted in histopathological report of clear cell carcinoma metastasis.
Factors that have been related to tumor seeding and portsite metastasis can be divided into 3 categories: tumor-related, wound-related and surgical technique-related.
Conclusions: Port-site metastasis in urological laparoscopic surgery is very rare. Multiple factors have been associated with tumor seeding, but tumor grade and stage appear to play a major role.


REFERENCES

  1. Castillo OA, and Vitagliano G. Port site metastasis and tumor seeding in oncologic laparoscopic urology. Urology 2008;71:372–378.

  2. Rassweiler J, Ander TA, Kumar R, Lymberakis K, Schulze M, Seeman O and Frede T. Oncological safety of laparoscopic surgery for urological malignancy: experience with more than 1,000 operations. J Urol 2003; 169:2072-5.

  3. Ost MC, Tan BJ and Lee BR. Urologic laparoscopy: basic physiological considerations and immunological consequences. J Urol 2005;174: 1183–8.

  4. Rane, AA, Eng MK , Keeley FX Jr. Port site metastases. Curr Urol 2008;18(2):185-189.

  5. Curet MJ. Port site metastases. Am J Surg 2004; 187: 705–12.

  6. Tsivian A, Sidi AA. Port site metastases in urological laparoscopic surgery. J Urol 2003;169(4):1213-8.




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