title: Umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer: a true port-site metastasis?
abstract: BACKGROUND
  We present a case of umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer.
  
  
  METHODS
  A 59-year-old woman with stage IIIB cervical adenocarcinoma underwent laparoscopic paraaortic lymphadenectomy as well as a conventional laparoscopy to assess the presence of peritoneal carcinomatosis. The pathologic examination revealed metastasis in one paraaortic node. Peritoneal cytology proved negative for malignant cells. Seven months after completion of chemoradiotherapy, the patient presented a 2.5-cm umbilical tumor involving the trocar tract together with recurrence of the cervical mass. Histological examination of the excised umbilical mass showed recurrence of the cervical adenocarcinoma, with strong peritumoral CD31 immunocytochemical expression.
  
  
  CONCLUSIONS
  The peritumoral increase in microvessel density and strong CD31 positivity suggests angiogenesis as a potential factor lead to seeding of tumor cells at the umbilical port.
authors.affiliation: Department of Obstetrics and Gynecology, Unit of Gynecologic Oncology, Hospital Materno-infantil Vall d'Hebron, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Martínez-Palones
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil-Moreno
authors.forename: María A
authors.initials: MA
authors.lastname: Pérez-Benavente
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Giménez
authors.forename: Jordi
authors.initials: J
authors.lastname: Xercavins
mesh_terms: D000008:Abdominal Neoplasms / Q000556:secondary*; D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008197:Lymph Node Excision / Q000009:adverse effects; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009366:Neoplasm Seeding; D012187:Retroperitoneal Space; D014472:Umbilicus / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery