Metastases in trocar sites secondary to gallbladder adenocarcinoma

Fortuitous systematic histological examination discovery of gallbladder adenocarcinoma after laparoscopic cholecystectomy performed due to acute cholecystitis is rare. It requires reoperation through subcostal approach for vesicular bed resection as well as excision of the trocar trajectories. We here report the case of a 73-year old female patient with a history of laparoscopic surgery for acute cholecystitis performed three years before. Anatomopathological examination had showed tubulo-papillary adenocarcinoma of the vesicle, but the patient refused reoperation. Currently, she presented with two masses in the anterior abdominal wall, one of which was ulcerated. Abdominal CT scan objectified two parietal and peritoneal tissue masses and CA19-9 dosage was largely positive at 946 U/ml (30 times the normal value). Biopsy under local anesthesia confirmed tumor recurrence and the patient was referred to the Department of Oncology for GEMOX chemotherapy before revaluation for possible surgery.