title: Port site and peritoneal metastases after robot-assisted radical prostatectomy.
abstract: BACKGROUND
  Port site metastasis after minimally invasive urologic surgery is a rare event despite the widespread utility of laparoscopic techniques in the management of urologic malignancies. Herein, we report a case of port site metastasis after robot-assisted radical prostatectomy.
  
  
  METHODS
  A currently 77-year-old male patient, who was diagnosed with cT2c, Gleason 7 (4+3) prostate adenocarcinoma in our clinic back in 2009, had undergone robot-assisted radical prostatectomy elsewhere. Histopathological examination revealed pT3a, Gleason 9 (4+5) disease. Lymph nodes were negative, however surgical margins were positive on the right side. PSA recurred after 9 months and maximal androgen blockade was initiated. Despite antiandrogenic manipulations, PSA reached 0.83ng/ml, 33 months postoperatively. Concurrently, we noticed a palpable anterior abdominal mass which demonstrated metabolic hyperactivity on PET scanning. Percutaneous biopsy of the lesion confirmed the presence of metastatic adenocarcinoma. PSA did not normalize after the complete excision of the metastatic focus. Repeated PET scan revealed multiple implants on the peritoneal surfaces of various organs.
  
  
  CONCLUSIONS
  Port site and peritoneal metastasis of prostate cancer after robot-assisted radical prostatectomy has not been reported so far. This peculiar dissemination pattern is most probably the result of tumor biology and perioperative factors.
  
  
  CONCLUSIONS
  Although encountered extremely rarely, surgeons should be aware of the possibility of port site and/or peritoneal metastases after minimally invasive radical prostatectomy.
authors: Department of Urology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey. Electronic address: omer_acar_@hotmail.com.
authors: Omer
authors: O
authors: Acar
authors: Department of Urology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey; School of Medicine, Koc University, Rumelifeneri Yolu, 34450 Istanbul, Turkey.
authors: Tarık
authors: T
authors: Esen
authors: Department of Medical Oncology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey.
authors: Sevil
authors: S
authors: Bavbek
authors: Department of Pathology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey.
authors: Onder
authors: O
authors: Peker
authors: Department of Urology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey.
authors: Ahmet
authors: A
authors: Musaoğlu
keywords: Metastasis; Port-site; Radical prostatectomy; Robot