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Abstract
Introduction/Background The use of laparoscopy for the treatment of ovarian cancer recurrences is very controversial. However, based on the published evidence, it can be very useful for tumor debulking in selected cases. We present a case of hepatic second relapse completely resected by laparoscopy.
Methodology A 37-year-old patient presented her second relapse of granulosa cell tumor in segment VI of liver, cranially to Morrison pouch (figure 1). The area was previously operated 18 months before due to carcinomatosis (first relapse) at that point. AT the time of surgery it measured 25 mm in largest diameter. CT scan and PET-CT did not show any other intra-abdominal or extra-abdominal disease. A laparoscopic resection was planned to perform the tertiary cytorreduction.
Hepatic second relapse in granulosa cell tumor
Results One umbilical 10 mm-trocar was placed at the umbilicus, and 3 accessory 5 mm-trocars as shown in figure 2. Full inspection of abdominal cavity and assessment of no other disease was performed. Careful dissection of Morrison pouch was carried out that was completely covered in adhesions. After that, we followed the right renal surface to reach the most cranial aspect of the segment VI of liver. The relapse was identified and removed without incidences.
Trocar disposition to reach segment VI of liver]
Conclusion Laparoscopic approach to perform tertiary cytoreduction is feasible in very selected cases, and it should be considered when single relapse is evidenced and it is accesible to laparoscopy.
Disclosure Nothing to disclose