Delayed Multiple Port Sites Metastases After Laparoscopic Radical Prostatectomy

Brusabhanu Nayak, MS, MCH, Prem Nath Dogra, MS, MCH, Vaibhav Saxena, MS, MCH, Ashis Saini, MS, MCH

Department of Urology, All India Institute of Medical Sciences, New Delhi, India (all authors).

ABSTRACT

Introduction: Laparoscopic port site metastases are recurrent nodular lesions developing locally in the abdominal wall within the scar tissue of one or more trocar sites. We are reporting an extremely rare case of delayed multiple port site metastases 3 years after laparoscopic radical prostatectomy. In this case, 3 port site metastases appeared 3 years after laparoscopic radical prostatectomy.

Case Description: A 65-year-old man was evaluated for lower urinary tract symptoms and found to have raised serum prostate-specific antigen of 9.06 ng/mL. Transrectal ultrasonography-guided biopsy of the prostate revealed an adenocarcinoma of the prostate (Gleason score 3 4 7), with 5 of 12 cores positive for tumor. Contrast-enhanced computed tomography showed localized disease with no involvement of seminal vesicle or lymph nodes. The bone scan was normal. He underwent laparoscopic radical prostatectomy for localized carcinoma of the prostate. He developed 3 port site metastases 3 years after surgery. In view of multiple port site metastatic disease, bilateral orchiectomy was done. The patient is doing well after 1 year of follow-up.

Conclusion: We report an occurrence of delayed multiple port site metastases after laparoscopic radical prostatectomy. The 3 sites of metastases in our case included the extraction site, the most active instrument site, and the drain placement site.

Key Words: Laparoscopy, Metastases, Multiple, Port sites, Radical prostatectomy.

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