Robotic port-site and pelvic recurrences after robot-assisted laparoscopic radical hysterectomy for a stage IB1 adenocarcinoma of the cervix with negative lymph nodes

Int J Med Robot. 2010 Jun;6(2):132-5. doi: 10.1002/rcs.295.

Abstract

Background: Port-site metastasis (PSM) following minimally invasive surgery for gynaecological cancer has been recognized as a potential problem over the last two decades.

Methods: A 60 year-old woman with stage Ib1 adenocarcinoma of the cervix was treated with radical hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic lymph node dissection, using robot-assisted laparoscopy.

Results: Eighteen months after primary surgery, the patient developed a pelvic recurrence invading both the bladder mucosa and the parametrium. During the routine recurrence work-up, we found an 8 mm robotic port-site metastasis (PSM) on the abdominal computed tomography (CT) scan.

Conclusion: This is the first case report emphasizing the risk of PSM and early pelvic recurrences in robot-assisted laparoscopic radical hysterectomy and bilateral pelvic lymph node dissection for an early-stage cervical adenocarcinoma patient with negative lymph nodes, histologically examined by immunohistochemical ultrastaging.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery*
  • Adnexa Uteri / pathology
  • Adnexa Uteri / surgery
  • Amputation, Surgical
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / secondary
  • Endometrial Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures
  • Humans
  • Hysterectomy / methods*
  • Laparoscopy / methods
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Middle Aged
  • Neoplasm Staging
  • Pelvis / pathology
  • Pelvis / surgery
  • Recurrence
  • Time Factors
  • Treatment Outcome
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / secondary
  • Uterine Cervical Neoplasms / surgery*