Descoberta simultânea de carcinomatose disseminada e carcinoma de cólon, após colecistectomia laparoscópica

Descoberta simultânea de carcinomatose disseminada e carcinoma de cólon, após colecistectomia laparoscópica

Alternative title Unsuspected colon adenocarcinoma revealed after laparoscopic cholecystectomy
Author Azevedo, João Luiz Moreira Coutinho Autor UNIFESP Google Scholar
Matos, Delcio Autor UNIFESP Google Scholar
Azevedo, Otávio Cansanção Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hospital do Servidor Público Estadual de São Paulo
Abstract A particularly rapid and fatal outcome has been noted in cases of malignant soft-tissue metastases occurring after cancer surgery. Abdominal wall metastases occurring in scars after laparotomy for cancer resection show a similar poor outcome. On the other hand, neoplasm seeding at trocar sites after laparoscopy has been reported with an increasing frequency. A case is presented of a 68-years-old woman with metastatic seeding of non-diagnosed colon cancer at the umbilical trocar site used for a laparoscopic cholecystectomy. The gallbladder was extracted through the umbilical incision. Pathological examination confirmed chronic cholecystitis. Eight months latter, the patient was seen with a tender umbilical mass protruded through a 4,5 cm the umbilical incision site. Biopsies of this tissue were taken and histopathological examination showed metastatic adenocarcinoma, probably of a gastrointestinal origin. A colonoscopy performed at the same time revealed a 2-cm lesion at the hepatic flexur which was shown to be a differentiated adenocarcinoma. An 8.0 x 6.0 x 6.0-cm pelvic mass without signs of liver metastases was identified by computerised tomography. Diagnostic laparoscopy showed a diffuse peritoneal carcinomatosis. The pelvis could not be approached, except for simple biopsy, and no surgical procedure was performed. It is presumed that the primary colon cancer existed prior to cholecystectomy. Laparoscopy is the procedure of choice to perform cholecystectomy and fundoplication. It has also been increasingly used to diagnose, resect and perform the staging of malignant tumours. As in any relatively new technique, questions arising about its safety and risk of complications must be extensively studied. Many questions about the specific features of laparoscopy promoting cancer growth remain unanswered.
Keywords Neoplasm metastasis
Colorectal neoplasm
Laparoscopy
Cholecystectomy
Language Portuguese
Date 2000-08-01
Published in Revista do Colégio Brasileiro de Cirurgiões. Colégio Brasileiro de Cirurgiões, v. 27, n. 4, p. 284-286, 2000.
ISSN 0100-6991 (Sherpa/Romeo)
Publisher Colégio Brasileiro de Cirurgiões
Extent 284-286
Origin http://dx.doi.org/10.1590/S0100-69912000000400011
Access rights Open access Open Access
Type Article
SciELO ID S0100-69912000000400011 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1005

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