We report a case of solitary port-site recurrence after laparoscopy-assisted distal
gastrectomy for advanced
gastric cancer. A 66-year-old man had previously undergone laparoscopy-assisted
gastrectomy with regional
lymph-node dissection for advanced
gastric cancer, which was a poorly differentiated
adenocarcinoma invading the subserosal layer with lymphatic infiltration and no
lymph-node metastases. He experienced dull
pain in the left upper quadrant of the abdomen 42 months after the surgery. On physical examination, erythematous induration of the skin around the
scar of the port insertion was observed in the left upper quadrant of the abdomen. Abdominal ultrasonography and contrast-enhanced computed tomography revealed a subcutaneous lesion with a well-defined mass measuring 3.0 cm in diameter located in the left upper quadrant of the abdomen. A skin biopsy revealed a metastatic
adenocarcinoma from
gastric cancer. Since there was no evidence of further metastatic lesions in other organs, the patient underwent surgical resection of the metastatic
tumor arising at the port site. The abdominal wall
tumor was resected with a leaf-skin incision and an adequate safety margin, and the inferior border of the
tumor reached the muscular layer, which was resected with the
tumor. Pathological examination confirmed the diagnosis of a poorly differentiated
adenocarcinoma in the subcutaneous tissue with invasion of the muscle layer at the port site. The postoperative course was uneventful;
chemotherapy using
oxaliplatin plus S-1 was administered, and the patient was in good health with no evidence of the disease for 3 months postoperatively. Although port-site
metastasis after laparoscopic
gastrectomy for
gastric cancer is a rare recurrence form, we should be aware of this issue, and further studies and assessments of additional cases are needed to establish a treatment strategy.