Unusual Port Site Metastasis Following Laparoscopic Resection of Ileal Neuroendocrine Tumor Evolving After a Prolonged Latency Period: 68Ga-DOTATATE PET/CT Documentation

Port site metastasis is an uncommon but clinically relevant complication, particularly associated with minimally invasive surgery for abdomino-pelvic malignancies, often indicating poor prognosis and necessitating prompt evaluation for potential surgical intervention. Proposed mechanisms include direct tumor implantation, aerosolization during pneumoperitoneum, surgical wound contamination, and immune alterations. In this report, we describe a case of a 48-year-old man who developed SSTR-expressing port site metastases, occurring 4 years and 4 months following laparoscopic resection of an ileal neuroendocrine tumor (NET). This case highlights the importance of long-term SSTR-based PET imaging surveillance in NET patients following minimally invasive surgery, even in the absence of symptoms or early biochemical relapse.