Late development of umbilical metastasis after laparoscopic cholecystectomy for a gallbladder carcinoma

A periumbilical mass developed 47 months after laparoscopic cholecystectomy . Pathologic examination of this mass showed features of moderately differe ntiated papillary adenocarcinoma, similar to that identified within the pre viously removed early stage (pT1b) gallbladder carcinoma. The cause of this 'late type recurrence' at the laparoscope port is unclear. 'Late type recu rrence' after laparoscopic cholecystectomy for gallbladder carcinoma has no t been reported previously. We reported a case with late periumbilical tumo r seeding at the navel trocar insertion site in a 65-year-old female. A rev iew of the preventative information of tumor recurrence and management is d iscussed. The use of gasless laparoscopy, slow desufflation, trocar site wa shout, wound protector and specimen bags are recommended.