Rapid development of umbilical metastases after laparoscopic cholecystectomy for unsuspected gallbladder carcinoma.

Unsuspected microscopic adenocarcinoma of the gallbladder was identified after operation in a 66-year-old woman undergoing elective laparoscopic cholecystectomy for symptomatic cholelithiasis. An abdominal wall metastasis developed at the periumbilical incision site through which the laparoscope was introduced and through which the gallbladder was removed. A review of the available information on tumor seeding of laparoscopic tracts and drain tracts is presented, as well as implications for the further management of gallbladder cancer and other intraabdominal malignancies.