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Abdominal wall metastasis of ovarian carcinoma after low transverse abdominal incision: report of two cases and review of literature
  1. A. Rafii*,
  2. G. Ferron*,
  3. M. Lacroix-Triki,
  4. F. Dalenc,
  5. L. Gladieff and
  6. D. Querleu*
  1. * Departments of Surgery, Institut Claudius Regaud Comprehensive Cancer Center, Toulouse, France
  2. Departments of Pathology, Institut Claudius Regaud Comprehensive Cancer Center, Toulouse, France
  3. Oncology, Institut Claudius Regaud Comprehensive Cancer Center, Toulouse, France
  1. Address correspondence and reprint requests to: Arash Rafii, MD, Department of Surgery, Institut Claudius Regaud, 20 Rue du Pont Saint Pierre, 31052 Toulouse, France. Email: rafii{at}icr.fnclcc.fr

Abstract

Occurrence of parietal metastases after surgery for a suspect adnexal mass may worsen the prognosis of the disease. However, it is not clear whether abdominal wall metastases is related to specific biologic features or simply to surgical mismanagement involving small incisions and traumatic extraction of the specimen, resulting in direct seeding of cancer cells. We report two cases with development of parietal dissemination of ovarian carcinomas after Pfannenstiel incision. The two patients needed parietal resection to obtain optimal surgical cytoreduction. Pfannenstiel incisions for exploration of suspicious adnexal masses increase the risk of extensive parietal metastasis in case of malignancy because they require reflection of several sheaths of tissue. The parietal extension of the disease may need major parietal resection that can worsen the functional and general outcome of the patients.

  • ovarian tumors
  • parietal dissemination
  • transverse incision

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