Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

2020 ◽  
Author(s):  
Lesheng Huang ◽  
Hongyi Li ◽  
Jun Chen ◽  
Jinghua Jiang ◽  
Wanchun Zhang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Left Lobe ◽  
Port Site ◽  
Laparoscopic Port ◽  
Missed Diagnosis ◽  
Upper Abdominal

Abstract Introduction: Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, a serious but rare condition may be happened, which is the missed diagnosis of intraperitoneal malignant tumor. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to the abdominal cavity or the abdominal wall. The missed laparoscopic malignant tumors are prone to metastasis, especially at the laparoscopic port-site. More extreme condition will be located in the navel, which is known as Sister Mary Joseph’s nodule(SMJN).Case presentation: A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that the most of tumor markers were increased. CT scan revealed that there was a diffused irregular and progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and multiple nodular lesions were found under the costal margin of the right upper abdominal wall, right lower abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed an infiltrative or metastatic middle differentiated adenocarcinoma. So the diagnosis was left lobe cholangiocarcinoma of the liver, multiple lymph nodes metastasis in the abdominal cavity and multiple implant metastasis in abdominal wall laparoscopic port-site and umbilical.Conclusion: In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, like gallstone in biliary system, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor or other lesions. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all the organs and tissues in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

scholarly journals Abdominal Wall Endometriosis That Developed at the Port Site after Laparoscopic Cholecystectomy

2016 ◽  
Vol 49 (6) ◽  
pp. 563-568
Author(s):  
Takashi Ishida ◽  
Hiroharu Shinozaki ◽  
Toshiaki Terauchi ◽  
Kazuhiro Endo ◽  
Masaru Kimata ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Port Site ◽  
Abdominal Wall Endometriosis

scholarly journals Rare case of synovial sarcoma of anterior abdominal wall in a young Indian male

2017 ◽  
Vol 4 (7) ◽  
pp. 2358
Author(s):  
Abhishek Katyal ◽  
Yash Patel
Keyword(s):  
Abdominal Wall ◽  
Synovial Sarcoma ◽  
Rare Case ◽  
Anterior Abdominal Wall ◽  
Close Association ◽  
Abdominal Cavity ◽  
Typically Develop ◽  
Synovial Sarcomas ◽  
Upper Abdominal ◽  
Malignant Soft Tissue

Synovial Sarcomas (synoviomas) are the fourth most common malignant soft-tissue tumours, and typically develop in para-articular locations of the extremities in close association with joint capsules, tendon sheaths, bursae and fascial structures. Other less common sites include the head and neck, abdominal wall, intra-abdominal cavity, and mediastinum. In this article, an interesting and rare case of a 25-year-old man with left upper abdominal lump is reported which was subsequently diagnosed as biphasic synovial sarcoma (spindle cell variety) of anterior abdominal wall. 

scholarly journals Malignant diseases in medicolegal practice

2007 ◽  
Vol 135 (1-2) ◽  
pp. 67-73
Author(s):  
Ljiljana Bogdanovic ◽  
Slobodan Savic ◽  
Gordana Basta-Jovanovic
Keyword(s):  
Lung Cancer ◽  
Cause Of Death ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Legal Responsibility ◽  
Medical Documentation ◽  
Female Group ◽  
Malignant Diseases ◽  
Natural Death

Introduction: In many cases of natural death (so-called obscure natural death), medicolegal assessment and elucidation are required. Although malignant tumors may be the cause of obscure natural death, their forensic significance has not been particularly studied in our population. Objective The objective of the study was to provide a general report on medicolegal importance of malignant diseases. Method Autopsy material of the Institute of Forensic Medicine, Belgrade, from 1990 to 2000, was analyzed. The data were obtained from autopsy records, investigation reports, family members of the deceased and available medical documentation. Results The malignant tumor was the cause of death in 81 cases (0.69% out of a total of 11771 autopsies), in 52 males and 29 females, respectively. The incidence of malignant diseases increased with age. The most frequent cause of death was the lung cancer - diagnosed in 33 cases (40.7% out of 81), with somewhat higher percentage in females (41.4%) than in males (40.4%), but this difference was not statistically significant (?2 =0.13; p>0.05). Other locations of malignancies were less frequently found: brain (7 cases), colon (6), stomach (5) and pancreas (4). In 67 cases, widespread tumor with metastases was identified as an immediate cause of death, in 8 cases there was a hemorrhage from eroded blood vessels, and in 6 cases peritonitis due to gastric or intestinal leakage into the abdominal cavity at the site of wall perforation. In 61.7% cases, fatal tumor was not diagnosed during the life, and was recorded more frequently in female group (75.9%) than in males (53.8%), but this difference was not statistically significant (?2=2.71; p>0.05). In most cases of lung cancer (22 or 66.7% out of 33), which was predominant type in the analyzed sample, malignancy remained unrecognized during the life. Conclusion The most important medicolegal problems regarding fatal malignant diseases are associated with exclusion of violent death in cases that are characterized as obscure (suspicious) natural death, as well as assessment of possible legal responsibility of medical staff in cases in which malignant tumor has not been diagnosed during the life.

Hepatocyte ultrastructural alterations in perimetastatic areas

1996 ◽  
Vol 54 ◽  
pp. 768-769
Author(s):  
H. J. Finol ◽  
M. E. Correa ◽  
L.A. Sosa ◽  
A. Márquez ◽  
N.L. Díaz
Keyword(s):  
Malignant Tumor ◽  
Malignant Tumors ◽  
Surrounding Tissue ◽  
Ultrastructural Changes ◽  
Pancreas Carcinoma ◽  
Duct Carcinoma ◽  
Tissue Samples ◽  
Primary Malignant Tumor ◽  
Transmission Electron ◽  
Remote Sites

In classical oncological literature two mechanisms for tissue aggression in patients with cancer have been described. The first is the progressive invasion, infiltration and destruction of tissues surrounding primary malignant tumor or their metastases; the other includes alterations produced in remote sites that are not directly affected by any focus of disease, the so called paraneoplastic phenomenon. The non-invaded tissue which surrounds a primary malignant tumor or its metastases has been usually considered a normal tissue . In this work we describe the ultrastructural changes observed in hepatocytes located next to metastases from diverse malignant tumors.Hepatic biopsies were obtained surgically in patients with different malignant tumors which metatastized in liver. Biopsies included tumor mass, the zone of macroscopic contact between the tumor and the surrounding tissue, and the tissue adjacent to the tumor but outside the macroscopic area of infiltration. The patients (n = 5), 36–75 years old, presented different tumors including rhabdomyosarcoma, leiomyosarcoma, pancreas carcinoma, biliar duct carcinoma and colon carcinoma. Tissue samples were processed with routine techniques for transmission electron microscopy and observed in a Hitachi H-500 electron microscope.

THE PROGNOSTIC VALUE OF PD-L1 EXPRESSION IN TUMOR AND IMMUNE CELLS IN SQUAMOUS CELL CARCINOMA OF THE ORAL MUCOSA

2017 ◽  
Vol 63 (5) ◽  
pp. 759-765
Author(s):  
Svetlana Kutukova ◽  
Natalya Belyak ◽  
Grigoriy Raskin ◽  
Marina Mukhina ◽  
Georgiy Manikhas ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Malignant Tumor ◽  
Immune Cells ◽  
Prognostic Value ◽  
Hard Palate ◽  
Malignant Tumors ◽  
Small Cell ◽  
Alveolar Process ◽  
Small Cell Lung ◽  
Lower Jaw

The most frequent of malignant tumor cites of the oral mucosa are tongue - 55 %, mucosa of the cheek - 12 %, the fundus of the oral cavity - 10 %, the alveolar process of the upper jaw and the hard palate - 9 %, the alveolar process of the lower jaw - 6 %, the soft palate - 2 %. Malignant tumor cells carry PD-L1 ligands on their surface and its expression level is often correlated with an unfavorable prognosis in particular for such tumors as melanoma, kidney cancer and non-small cell lung cancer. It is relevant to evaluate the correlation between overexpression of PD-L1 and overall survival in patients with malignant tumors of the oral mucosa.

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

Sign in / Sign up

Export Citation Format

Share Document