Tumor implants after thoracoscopic resection of a metastatic sarcoma

Tumor implantation after video-assisted thoracic operations is rare. We describe the case of a 61-year-old woman who underwent an apparently uneventful thoracoscopic resection of a solitary pulmonary metastasis from a primary limb sarcoma. Within 3 months, extensive trocar and diaphragmatic implants developed that required an extensive en bloc resection of her chest wall, diaphragm, and lung. Because of the aggressive biologic behavior of sarcomas and their potential to grow in surgical tracts, concern is raised about the advisability of using videoassisted thoracic surgical techniques in the management of these tumors.