Progressive Ovarian Cancer with Trocar Site Metastases Resulted from Inadequate Laparoscopy

Sigit Purbadi, Ina Damayanti
In: Indonesian Journal of Obstetrics and Gynecology · 2014 · pp. 110–113 · doi:10.32771/inajog.v2i2.417 · W1509515787
Case report OA: gold CC0
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by qwen3.7-flash, 2026-09-19 ⓘ

A case report describes progressive ovarian cancer with trocar site metastases following laparoscopic removal of a cyst initially diagnosed as endometriosis, highlighting risks of tumor seeding from inadequate surgical technique.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-10-27 · read from full text ⓘ

This case report describes a 52-year-old woman who developed progressive ovarian clear cell adenocarcinoma with trocar site metastases following an inadequate laparoscopic procedure for suspected ovarian malignancy. The initial surgery involved rupturing the cyst, maintaining high CO2 pressure, and retrieving tissue without a containment bag, despite frozen section results indicating endometriosis rather than cancer. Subsequent imaging revealed intra-abdominal implants and omental cake adhered to previous trocar sites, leading to debulking laparotomy after chemotherapy failed to control the disease. The authors conclude that improper surgical technique during laparoscopy for potentially malignant lesions can cause tumor seeding, emphasizing the need for careful preoperative evaluation and strict retrieval protocols. This paper is centrally about endometriosis — specifically, the misdiagnosis of endometriosis as benign led to inappropriate surgical management that resulted in advanced ovarian cancer progression.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Objective: Discuss the complications of laparoscopic ovarian cystic neoplasms. Method: Case report A-52 year old female with 2 parities, complained of a lump at anterior abdominal wall during chemothe rapy for clear cell ovarian adenocarcinoma after total hysterectomy and bilateral salphingooophorec tomy by lapa roscopy. The indication was suspected ovarian cancer from solid parts found during ultrasound and CA125 level 169. During previous laparoscopy, the cyst was ruptured, left in abdominal cavity with high C02 pressur e for five hour s and retrieved without a bag.The frozen section examination of the cyst wallwere diagnosed as endometriosis.The physician assured her that the lump was only scar and did not need further evaluation. CA125 level was 557 IV after chemotherapy. PET scan confirmed a 2 ern-diameter mass superior to periton eum and multiple implants intra abdominally. Result: Adebulking laparotomy was done. Omental cake was found with one part adhered to the right previous trocar insertion site. It was connected to tumor implant size 3x4 em until fat tissue of abdomen wall.Another implant was also found at left para colical area . Conclusion: Laparoscopy offers advantages such as less bleeding, better visualisation, and enhanced recovery. Some controversies exist in cases with suspicion of malignancy. Pneumoperitoneum might cause seeding of tumor cells. This could be prev ented by using low pressure, avoidance of exsuflation of gas through tro car opening, or by using bags to retrieve operative specimens. Preoperative evaluation of clinical findings, ultra sound, and tumor markers are important to prevent improper surgical management. Keywords: complication, laparoscopy, metasta ses, ovarian cancer, trocar site.
Full text 1,899 characters · extracted from oa-doi-fallback · 5 sections · click to expand

Objective

Discuss the complications of laparoscopic ovarian cystic neoplasms.

Method

Case report A-52 year old female with 2 parities, complained of a lump at anterior abdominal wall during chemothe rapy for clear cell ovarian adenocarcinoma after total hysterectomy and bilateral salphingooophorec tomy by lapa roscopy. The indication was suspected ovarian cancer from solid parts found during ultrasound and CA125 level 169. During previous laparoscopy, the cyst was ruptured, left in abdominal cavity with high C02 pressur e for five hour s and retrieved without a bag.The frozen section examination of the cyst wallwere diagnosed as endometriosis.The physician assured her that the lump was only scar and did not need further evaluation. CA125 level was 557 IV after chemotherapy. PET scan confirmed a 2 ern-diameter mass superior to periton eum and multiple implants intra abdominally.

Result

Adebulking laparotomy was done. Omental cake was found with one part adhered to the right previous trocar insertion site. It was connected to tumor implant size 3x4 em until fat tissue of abdomen wall.Another implant was also found at left para colical area .

Conclusion

Laparoscopy offers advantages such as less bleeding, better visualisation, and enhanced recovery. Some controversies exist in cases with suspicion of malignancy. Pneumoperitoneum might cause seeding of tumor cells. This could be prev ented by using low pressure, avoidance of exsuflation of gas through tro car opening, or by using bags to retrieve operative specimens. Preoperative evaluation of clinical findings, ultra sound, and tumor markers are important to prevent improper surgical management.

Keywords

complication, laparoscopy, metasta ses, ovarian cancer, trocar site.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. The paper's references may be in our DB but unresolved to ``paper_id`` (resolution happens at ingest when the cited DOI matches a row we already have). Run the cross-source citation reconcile pass to retry.

References (10)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK