CT of abdominal wall implantation metastases after abdominal percutaneous procedures

Purpose: Our goal was to report the CT manifestations of abdominal wall implantation metastases occurring after abdominal percutaneous procedure. Method: CT scans and clinical data of six patients with abdominal wall implantation metastases at the puncture site following abdominal percutaneous procedure were reviewed. The abdominal percutaneous procedures included drainage of intraperitoneal abscess in patients with colon or gastric cancer (n = 2), transhepatic biliary drainage in a patient with hilar cholangiocarcinoma (n = I), biopsy of intrahepatic hepatocellular carcinoma (n = I), biopsy of a metastatic left adrenal gland (n = 1), and laparoscopic cholecystectomy in a patient with unsuspected gallbladder cancer (n = 1). Results: CT enabled the diagnosis of abdominal wall implantation metastasis in all six patients and showed coexisting intraabdominal tumor sites in five patients. All abdominal wall implantation metastases were homogeneous before intravenous administration of iodinated contrast material and became moderately heterogeneous on contrast-enhanced CT scan with marked enhancement relative to adjacent tissues. Conclusion: Abdominal wall implantation metastases are moderately heterogeneous on contrast-enhanced CT scan with marked enhancement relative to adjacent tissues. In most cases of abdominal wall implantation metastasis following abdominal percutaneous procedure, CT shows additional intraabdominal tumor sites. This complication may occur following a variety of abdominal percutaneous procedures (either radiological or surgical).