Isolated subcutaneous implantation of a borderline ovarian tumor: A case report and review of the literature

Table 1 Literature review of studies focusing on laparoscopy-related port-site metastasis

Ref.	No. of patients	Cohort	Type of surgery	Results
Chua et al[9], 2011	11027 from 17 studies	Various cancers (colon, rectal, gynecological, gastric, liver, urological)	Laparoscopic surgery or diagnostic surgery for malignant abdominal disease	The incidence of PSM is low (< 2%); in eight randomized trials comparing laparoscopy to open surgery for cancer, there was no statistical difference in the development of PSM or wound metastasis (none of these eight trials included gynaecological cancer patients)
Zivanovic et al[1], 2008	1694 (retrospective analysis of all laparoscopies in a 16-yr period)	Various gynecological cancers (ovarian, perotineal, uterine, cervical)	Laparoscopy in women with malignant disease	Laparoscopy-related subcutaneous tumor implantation occurred in 20 cases (1.18%); only one case of “isolated” PSM was reported; subcutaneous tumor implantations usually occurred with carcinomatosis, with synchronous metastases to other sites; patients whose preceding laparoscopy was performed for advanced or recurrent abdominopelvic disease were more at risk for developing PSM; patients who developed PSM within 7 mo after laparoscopy had a median survival of 12 mo compared to 37 mo in patients who developed PSM > 7 mo after laparoscopy
Martínez et al[10], 2010	1216 (retrospective analysis of all laparoscopies)	Uterine (921) and cervical (295) cancer	Laparoscopy in women with malignant disease	The overall incidence of PSM was very low (0.4% per procedure) after a median follow-up of 49 mo; the median time to the development of PSM was 8 mo; patients with peritoneal carcinomatosis were most at risk for developing PSM
Ndofor et al[8], 2011	181	Various gynecological cancers (uterine, cervical, ovarian)	Robotic surgery (DaVinci Surgical system) in women with malignant disease	PSM occurred in two cases (1.1%); there were no cases of isolated PSM
Heitz et al[5], 2009	66	Ovarian cancer	Laparoscopy followed by cytoreductive laparotomy with resection of port sites	Port site metastasis were present in 47% of patients; patients with ascites, higher tumor stage and peritoneal carcinomatosis were more at risk of developing PSM

PSM: Port site metastases.