Abstract:

Port site metastasis (PSM) is a rare complication of abdominal paracentesis drainage in ovarian cancer, referring to the occurrence of tumor tissue within the subcutaneous tissue at or adjacent to the puncture site. This report presents a case of PSM secondary to abdominal paracentesis drainage in a patient with advanced ovarian cancer. The patient presented with abdominal distension. Ultrasonography and contrast-enhanced CT revealed massive ascites. Abdominal paracentesis drainage was performed, and cytopathological examination of the ascitic fluid confirmed serous carcinoma of gynecological origin. Platinum-based neoadjuvant chemotherapy was initiated, with bevacizumab added during the first cycle. Approximately one month after the paracentesis, the patient self-palpated a mass in the left lower abdomen. Ultrasonography revealed a hypoechoic nodule within the superficial fascia layer of the left abdominal wall. After three cycles of neoadjuvant chemotherapy, interval tumor cytoreductive surgery and resection of the abdominal wall lesion were performed. Postoperative pathology confirmed that the abdominal wall mass represented a metastasis from ovarian cancer. The patient has been followed up regularly, and no recurrence has been observed at the abdominal wall site. Combined with a review of relevant literature, this report further discusses the risk factors, pathogenesis, and prevention strategies for PSM following abdominal paracentesis drainage in advanced ovarian cancer.

Key words: Paracentesis, Ovarian neoplasms, Carcinoma, Neoplasm metastasis, Genes, BRCA1, Abdominal paracentesis drainage, Port site metastasis