title: Axillary lymph node metastasis following resection of abdominal wall laparoscopic port site recurrence of gallbladder cancer.
abstract: Abdominal wall port site recurrence of gallbladder cancer is well described in the literature in patients that have undergone laparoscopic cholecystectomy with the incidental finding of a gallbladder cancer. The etiology and consequences of this type of metastatic recurrence are unclear. This report describes two cases with the unique sequelae of the interval development of nodal metastases to the axillary lymph nodes following resection of an abdominal wall laparoscopic port site recurrence of gallbladder cancer. The first case involves a patient who developed an isolated left axillary lymph node metastasis approximately 10 months after undergoing resection of a left-sided abdominal wall port site recurrence for a T2 gallbladder cancer. The original tumor had been found at laparoscopic cholecystectomy and definitively treated surgically approximately 3 years earlier. The second case involves a patient who developed isolated nodal metastases to the right axillary lymph nodes approximately 4 months after undergoing resection of right-sided abdominal wall port site recurrence, segment 4/5 hepatic resection, and portal lymphadenectomy for a T2 gallbladder cancer. This tumor had originally been found at laparoscopic cholecystectomy approximately 1 year earlier. These unique sequelae of the interval development of nodal metastases to the axillary lymph nodes demonstrated in both cases has not been previously reported.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, N-924 Doan Hall, 410 West 10th Avenue, 43210-1228, Columbus, OH, USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Povoski
authors.forename: James R
authors.initials: JR
authors.lastname: Ouellette
authors.forename: William W L
authors.initials: WW
authors.lastname: Chang
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
mesh_terms: D034861:Abdominal Wall; D000368:Aged; D001365:Axilla; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D041761:Cholecystolithiasis / Q000453:epidemiology; D015897:Comorbidity; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D011677:Punctures