Port-site metastases of adenocarcinoma of the fallopian tube after laparoscopically assisted vaginal hysterectomy and salpingo-oophorectomy

Port-site metastases following laparoscopic surgery for cancer constitute an emerging problem. We report a case of cutaneous metastasis at a port site following laparoscopically assisted vaginal hysterectomy and salpingoo-ophorectomy for unsuspected adenocarcinoma of the fallopian tube. This complication occurred 7 months postoperatively and was treated with resection. A single site was involved. Possible etiologies are implantation from ''contaminated'' instruments or dissemination of tumor cells by the positive-pressure pneumoperitoneum. Preventive measures include precise and clean surgical technique, the use of a nonporous bag, postoperative trocar-site excision or irradiation, and conversion to laparotomy either intra- or postoperatively.