title: [Port-site metastasis of an upper urinary tract urothelial carcinoma after laparoscopic nephroureterectomy: a case report].
abstract: We report here a case of ureteral cancer in which port-site metastasis was suspected after a nephroureterectomy. The patient was a male in his fifties with a chief complaint of asymptomatic gross hematuria. A tumor was found in his left renal pelvis and ureter by a computed tomographic (CT) scan. The patient was diagnosed with a left upper urinary tract cancer with a clinical stage of T2N0M0. A left laparoscopic nephroureterectomy was performed through a retroperitoneal approach. Lymph node dissection was performed with an ultrasonic surgical knife. The pathological diagnosis was an urothelial carcinoma, grade 2 > 3, INFbeta, pT3, pV1, pN2. He received two courses of MVAC chemotherapy (methotrexate 50 mg, vinblastine 5 mg, adriamycin 50mg, cisplatin 120 mg) postoperatively. Since retroperitoneal lymph node metastasis was observed three months later on a CT scan, the MVAC chemotherapy was repeated for three courses. Nine months later, a tumor was found in the hypodermic beside the port-site, and a needle biopsy confirmed a metastatic urothelial carcinoma. He received two courses of GP chemotherapy (gemcitabine 4,250 mg, paclitaxel 225 mg). He died of multiple metastases five months later.
authors.affiliation: Department of Urology and Andrology, Kansai Medical University.
authors.forename: Kaneki
authors.initials: K
authors.lastname: Yasuda
authors.forename: Gen
authors.initials: G
authors.lastname: Kawa
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D009392:Nephrectomy / Q000009:adverse effects; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000473:pathology* / Q000601:surgery*