• Abdullah Aloraini, Khaled Alshehri, Rahaf Alshammari, Abdulhakim Bin Onayq, Mohammed Ayesh, Malak Alzahrani, Sulaiman A AlShammari, and Faisal Alsaif.
• General, HPB & Transplant Surgeon, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
• Medicine (Baltimore). 2024 May 3; 103 (18): e37880e37880.

IntroductionIncidental gallbladder carcinoma refers to a discovery of gallbladder cancer during or after cholecystectomy. Late port-site metastasis (PSM) following Laparoscopic cholecystectomy (LC) is rare with an incidence rate of 10.3%.Patient ConcernsWe report a case of a 58-year-old man who presented with a painful abdominal wall mass for 6 weeks. He had a history of LC for symptomatic cholelithiasis, 8 years prior.DiagnosisHistopathological examination revealed a positive result for metastatic adenocarcinoma from the abdominal wall mass. Moreover, Positron emission tomography (PET) showed a small focus of intense fluorodeoxyglucose (FDG) uptake in the gallbladder bed, which was highly suspicious for malignancy.InterventionDecision was to proceed with surgery owing to uptake in the gallbladder bed with single-site metastasis to the previous port site. In addition, in the board meeting, an agreement was reached for performing distal pancreatectomy with splenectomy owing to uncertainty of malignancy based on what was discovered during the full metastatic workup. Diagnostic laparoscopy followed by midline laparotomy performed. Radical completion cholecystectomy with lymphadenectomy was done. Followed by complete resection of the anterior abdominal wall. Distal pancreatectomy and splenectomy were then performed.OutcomePathological diagnosis showed metastatic/invasive, moderately differentiated adenocarcinoma with positive margins on the posterior surface of excised port-site mass. The positive margins necessitated further chemoradiotherapy, followed by adjuvant chemotherapy until lung metastasis was identified. After this, the patient was scheduled for palliative chemotherapy.ConclusionPresence of PSM is often associated with peritoneal metastasis. For this reason, it is advised to evaluate the patient for possible metastasis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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