Port site metastasis by exfoliated cells from occult cholangiocarcinoma a case report

ABSTRACT

A forty year old man underwent laparoscopic cholecystectomy for symptomatic gall stones. The histological report of removed gall bladder was benign. The patient presented with a nodule at port site one year after the cholecystectomy. The nodule was removed and histopathology revealed adenocarcinoma. Histopathological review of the removed gallbladder again revealed a benign result. All investigations for diagnosis of primary remained equivocal. The patient again presented with obstructive jaundice three months after removal of the nodule. Investigations [CT Scan and ERCP] revealed a nodule at hilum of biliary ducts causing obstruction at that level with dilatation of intrahepatic Nary ducts. Brush cytology revealed hilar cholangiocarcinoma. This case illustrates that exfoliated cells of bile duct tumour metastasized by transluminal route and caused port site metastasis after laparoscopic cholecystectomy. The patient is referred to hepatobiliary surgeon for further treatment