A case report of gallbladder carcinoma with port site recurrence only in the muscle layer of abdominal wall

稀な腹壁筋層内ポートサイト再発をきたした胆嚢癌の1例を経験したので報告する.症例は60歳代の女性.平成17年1月,総胆管結石に対して内視鏡的乳頭切開術を施行し,総胆管結石を排石した.胆嚢結石症に対してLaparoscopic Cholecystectomy(以下LC)を行ったが,術後病理検査にて胆嚢癌と診断された.総胆管切除+リンパ節郭清(D2)を施行し,術後補助化学療法を行った.平成20年7月,右季肋部にポートサイト再発を認め,腫瘤切除術を施行した.腹腔鏡下胆嚢摘出術後に胆嚢癌と診断される頻度は1%弱であり,そのうちポートサイト再発を来した症例は15.6%と報告されている.ポートサイト再発の多くは,腹膜から筋層浸潤したものとされるが,本症例では筋層のみと稀な再発形態であった.

We report a case of a recurred gallbladder carcinoma in the port site after laparoscopic cholecystectomy(LC).A 62 year-old female patient underwent endoscopic sphincteropapillotomy and LC for the treatment of cholecystolithiasis and choledocholithiasis in January 2005. In the pathological examination, she was diagnosed with gallbladder carcinoma. Common bile duct resection and D2 lymph node dissection were performed. She was followed by adjuvant chemotherapy. In June 2008, a port site recurrence was pointed out in the right hypochondrium. The tumor in the muscle layer was resected. The patients who are diagnosed with gallbladder carcinoma after LC are rare. 15.6% among them have had port site recurrence later. Many of the port site recurrences primarily develop in the subperitoneal layer of the abdominal wall and invade the muscle layer, but our case is a rare one in which the recurrence developed only in the muscle layer.

胆嚢癌

ポートサイト再発