Port Site Metastases of Carcinoma Endometrium: Case Report and Literature Review

IntroductionCarcinoma endometrium with port site metastases usually have poor survival, we present a case of carcinoma endometrium with port site metastases that has survived for four years.An Interesting Case of Carcinoma Endometrium with Port Site MetastasesA 45-year-old was evaluated for excessive bleeding per vaginum of 6 months duration. Pipelle Biopsy was suggestive of Nonsecretory endometrium and she underwent Laparoscopic Assisted Vaginal Hysterectomy with bilateral salpingo-oopherectomy elsewhere on May 2018 (specimen removed via vault). There was no evidence to suggest any use of morcellators intraoperatively. Her postoperative histopathology revealed Papillary Serous Adenocarcinoma, high grade with less than 50% myometrial invasion [FIGO IA]. A CECT of the abdomen and pelvis was done during Postoperative day 15, which revealed an ill-defined soft tissue density lesion in the right paraumbilical region with surrounding fat-stranding. These features suggested a Port site metastasis. The patient was referred to our institution for an opinion. An image-guided biopsy of the paraumblical lesion revealed adenocarcinomatous deposits. Immunochemistry revealed ER & PR positivity. After obtaining Tumor board concurrence, 6 cycles of Paclitaxel and Carboplatin combination chemotherapy were administered. Post chemotherapy PET CT showed complete resolution of the disease. The patient was started on tablet Tamoxifen 10 mg BD & was kept on regular follow-up with PET CT taken at 6 monthly intervals. The patient is on hormonal therapy for the past 4 years and is healthy.ConclusionPort site metastases have usually a guarded prognosis. Certain patients have excellent responses to chemotherapeutic agents and tend to live longer.