Surgical Management of Oligometastatic Port Site Recurrence Following Robotic Assisted Gynaecological Cancer Surgery: A Case Report

Abstract

Aims: Port site recurrence is a rare complication of laparoscopic or robotic surgery for gynaecological cancer. The exact mechanism is not well understood and there are few cases detailing this phenomenon specifically after robotic assisted surgery for gynaecological cancer. The aim of this case report is to demonstrate how an oligometastatic port site recurrence can be managed following robotic surgery for cervical carcinoma. Presentation of Case and Discussion: The authors present a case of oligometastatic port site metastasis in a 49-year-old woman with Stage 1B1 grade 2 endocervical adenocarcinoma following primary robotic radical hysterectomy with lymph node dissection. The recurrence was diagnosed 16 months post primary surgery in the anterior abdominal wall and the lung. Both were resected with clear margins and the patient continued follow up. A further second ipsilateral port site recurrence was diagnosed 81 months after the initial surgery, this was also excised and the abdominal wall reconstructed with mesh. The patient is asymptomatic and disease-free 7.5 years after her initial diagnosis. Conclusion: Oligometastatic port site recurrence can be successfully managed by surgical excision in selected cases, however more research is required to develop better understanding of the mechanisms and risk factors for port site metastasis in different gynaecological cancers which would in turn help to improve clinical decision making.