PMC7448218_01
Contrast-enhanced computed tomography shows a right renal tumor (arrow) with a maximum diameter of 27 mm.
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A 69-year-old Japanese male with diabetes mellitus underwent right-sided retroperitoneal RPN for an incidental renal tumor (Figure 1).
Appearance of a mass underneath in right side of the abdominal wall (arrow). (a) Contrast-enhanced computed tomography. (b) [18F]fluorodeoxyglucose- (FDG-) positron emission tomography-computed tomography shows increased FDG uptake with a maximum standardized uptake value of 3.2.
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Follow-up computed tomography (CT) scan performed six months after the surgery revealed an emerging small mass below the right side of the abdominal wall coinciding with a 12 mm AirSeal  assistant port site (Figure 2(a)). FDG uptake with a maximum standardized uptake value of 3.2 (Figure 2(b)). Further evaluation did not reveal elevated levels of inflammatory markers in blood.
Intraoperative image reveals a mass (circle) observed in the peritoneal cavity.
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Tumor resection was subsequently performed by laparoscopic transperitoneal approach (Figure 3).
Histology of the mass at a port site showing aggregation of foamy histiocytes with lipogranulomas, mild infiltration of lymphocytes and plasma cells, and focal fibrosis.
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Histological examination revealed that the mass was composed of aggregation of foamy histiocytes with fat necrosis (FN), lipogranulomas, fibrosis, and mild infiltration of lymphocytes and plasma cells (Figure 4).