Highshaw Ralph A, Vakar-Lopez Funda, Jonasch Eric, Yasko Alan W, Matin Surena F
Department of Urology, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Eur Urol. 2005 Mar;47(3):357-60. doi: 10.1016/j.eururo.2004.11.008. Epub 2005 Jan 15.
Several surgical and technical mechanisms have been proposed for the development of port-site metastasis, but the influence of tumor and host biologic factors has not been emphasized. We present a case of a pelvic chordoma that metastasized to a prior laparoscopic radical nephrectomy port-site.
A 62-year-old woman underwent laparoscopic radical nephrectomy (LRN) for a pT1b grade 3 renal cell carcinoma, followed 6 weeks later by resection of a sacral chordoma. The incisions and areas of dissection for the two procedures were discontinuous.
Eight months following the LRN she developed a nodule in one of the laparoscopic port-sites. The port-site metastasis was treated with wide surgical resection, which was confirmed as metastatic chordoma on histologic examination.
Based on the chronological sequence and physical distance between surgical sites, only biological factors could have contributed to this port-site metastasis. This unusual case highlights the important role that tumor and host biologic mechanisms play in the development of port-site metastasis.
已经提出了几种关于端口部位转移发生的手术和技术机制，但肿瘤和宿主生物学因素的影响尚未得到强调。我们报告一例盆腔脊索瘤转移至先前腹腔镜根治性肾切除术端口部位的病例。
一名62岁女性因pT1b 3级肾细胞癌接受了腹腔镜根治性肾切除术（LRN），6周后又接受了骶骨脊索瘤切除术。这两个手术的切口和解剖区域是不连续的。
LRN术后8个月，她在一个腹腔镜端口部位出现了一个结节。该端口部位转移灶通过广泛手术切除进行治疗，组织学检查证实为转移性脊索瘤。
根据手术部位之间的时间顺序和实际距离，只有生物学因素可能导致了这种端口部位转移。这个不寻常的病例突出了肿瘤和宿主生物学机制在端口部位转移发生中所起的重要作用。
