title: Delayed and clinically isolated port site carcinosarcoma recurrence as an early indicator of disseminated disease.
abstract: A 71-year-old woman with suspected endometrial cancer underwent robotic-assisted hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection, and infracolic omentectomy revealing a stage II uterine carcinosarcoma with components of serous adenocarcinoma and undifferentiated spindle cell sarcoma. There was no evidence of distant metastasis at the time of surgery. However pelvic washings were positive for malignant cells. She received adjuvant chemotherapy and vaginal cuff brachytherapy. Forty months later she developed a subcutaneous mass at the location of previous port site which was confirmed to be recurrence of the uterine primary. She subsequently developed additional distant metastases to the abdominal wall, lungs, and bone. Port site metastasis (PSM) was the earliest indicator of disseminated metastatic disease in this patient. We review challenges in the management of patients with PSM and propose that PSM be considered as a sign of systemic disease even when presenting as an apparently isolated recurrence.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Western Connecticut Health Network, 24 Hospital Avenue, Danbury, CT 06810, United States.
authors.forename: Monica
authors.initials: M
authors.lastname: Dandapani
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Western Connecticut Health Network, 24 Hospital Avenue, Danbury, CT 06810, United States.
authors.forename: Brandon-Luke L
authors.initials: BL
authors.lastname: Seagle
authors.affiliation: Department of Pathology, Western Connecticut Health Network, 24 Hospital Avenue, Danbury, CT 06810, United States.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Chacho
authors.affiliation: Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, Suite 05-2168, Chicago, IL 60611, United States.
authors.forename: Shohreh
authors.initials: S
authors.lastname: Shahabi
keywords: Carcinosarcoma recurrence; PSM, port-site metastasis; Port site metastasis; Uterine carcinosarcoma