Intra-abdominal suture granulomas masquerading as colon carcinoma: a case report

Sharma, Sonam

doi:10.15406/acp.2018.03.00061

Cited by 5 publications

(12 citation statements)

References 26 publications

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“…Radiologically, suture granulomas can be mistaken as either primary malignancy or tumour recurrence in a surgically treated case of cancer. 1,[4][5][6][7][8] Rettenbacher et al, stated that suture granulomas would characteristically appear as hypoechoic lesion with hyperechoic single or double lines on USG. 9 But, most of the cases lack specific USG findings, like in this case.…”

Section: Discussionmentioning

confidence: 99%

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Suture granuloma masquerading as primary ovarian malignancy: a case report

Palo

2019

Int J Reprod Contracept Obstet Gynecol

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Suture granuloma is an uncommon surgical complication comprising of foreign body granulomatous tissue reaction against the suture material. We present a case of ovarian suture granulomas in a 28-year-old female who was clinico-radiologically misdiagnosed as ovarian carcinoma. She presented with intermittent pelvic pain, on and off low-grade fever and menstrual irregularities for 6 months and had undergone laparoscopic tubectomy two years back. Ultrasonographic findings were suspicious of left ovarian malignancy. CA-125 levels were elevated (115 U/mL). Left oophoro-salpingectomy was performed and histopathological examination revealed multiple suture-related granulomas.

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Section: Discussionmentioning

confidence: 99%

“…Both absorbable and nonabsorbable suture material can elicit such response and it usually tends to develop in early post-operative period. 1 Here, authors report an unusual case of ovarian suture granuloma which simulated as a primary ovarian malignancy.…”

Section: Introductionmentioning

confidence: 99%

Suture granuloma masquerading as primary ovarian malignancy: a case report

Palo

2019

Int J Reprod Contracept Obstet Gynecol

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“…A klinikai eset kivizsgálása során a képalkotó vizsgálatok alapján felvetettük, hogy az elváltozás megfelelhet az appendectomia késői szövődményének, azonban a beavatkozás óta eltelt hosszú idő, az előző héten elvégzett és kórjelző eltérést nem mutató hasi ultrahangvizsgálat, a ritka entitás, a kevés klinikai tapasztalat és az antibiotikumra adott nem kielégítő terápiás válasz megnehezítette az egyértelmű diagnózis megállapítását. A Schloffertumor esetén differenciáldiagnosztikai szempontból a perforáció, a tályog vagy a tumor [6] is szóba jön. Bár terápiája majdnem minden esetben a műtéti eltávolítás, pontos preoperatív diagnózis esetén kevésbé kiterjesztett műtét végezhető [7].…”

Section: Következtetésunclassified

Differenciáldiagnosztikai nehézséget okozó fonálgranuloma appendectomia után

Seszták

Kálmán

Aron

et al. 2021

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Összefoglaló. Az appendectomia szövődményei a leggyakrabban a korai posztoperatív időszakban jelentkeznek. A műtét után évekkel megjelenő szövődmény ritka. Egy 11 éves kislányt vizsgáltunk 2 hete fennálló hasi panaszok miatt. Anamnézisében 8 évvel ezelőtt hagyományos módon elvégzett appendectomia szerepel. Az Ausztriában készült első hasi ultrahangvizsgálat eltérést nem talált. Az intézetünkben elvégzett képalkotó vizsgálatok – hasi ultrahang, MR-vizsgálat – ileocoecalisan elhelyezkedő szolid terimét igazoltak, és felvetették a folyamat gyulladásos eredetét. A szerteágazó klinikai tünetek, a laboratóriumi és a képalkotó diagnosztikai eltérések kapcsán differenciáldiagnosztikai szempontból a gyulladásos bélbetegség lehetősége is felmerült, és biztonsággal a tumoros folyamatot sem sikerült kizárni. A rosszabbodó status miatt műtét történt. Ennek során a colon ascendenssel összefüggő, makroszkóposan tumoros megjelenésű elváltozást távolítottak el. A szövettani vizsgálat malignitást nem igazolt, a folyamat idegen test okozta – varróanyag-granuloma – krónikus gyulladásos jellegét erősítette meg. A vizsgálatok kapcsán coeliakia is igazolódott. A hasi műtétek ritka szövődménye a Schloffer-tumor, melyet idegen test típusú – gyakran sebészi varróanyag-maradvány körüli – granulomatosus gyulladásos folyamat jellemez. Az entitás ismerete differenciáldiagnosztikai szempontból fontos. Nehezítette a diagnózist az első hasi ultrahangvizsgálat negatív eredménye és az egyidejűleg manifesztálódó coeliakia. Orv Hetil. 2021; 162(3): 112–115. Summary. Generally, complications with appendectomy occur during the early postoperative stage and are quite rare years after the operation. In case of late manifestation of complications, the clinical signs are generally unspecific. We report a case of an 11-year-old girl – who underwent an appendectomy 8 years ago – with abdominal pain during the last 2 weeks. The first ultrasound examinations were carried out in Austria with normal results. In our department, the ultrasonography and the MR examinations showed an inhomogeneous abdominal mass which was connected to the abdominal wall and with the suspicion of inflammation. Because of the diversified results of radiology imaging and laboratory test, inflammatory bowel disease and tumor were considered in the differential diagnosis. During the operation, a tumor-like lesion related to the ascending colon was found. The histopathological examination revealed a foreign body type suture granuloma with a central abscess. Malignancy was not found. The clinical investigation proved celiac disease, too. The Schloffer tumor is a rare complication after abdominal surgery. This is a foreign body type inflammatory granuloma mainly around a surgical thread. The knowledge of the entity is important in differential diagnostic aspect. The presence of celiac disease in combination with the negative result of the first ultrasound examination made the exact diagnosis more difficult. Orv Hetil. 2021; 162(3): 112–115.

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“…3 School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC. 4 Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.…”

Section: Fundingmentioning

confidence: 99%

“…Postoperative surveillance following radical colectomy is vital to the successful treatment of colorectal cancers, and various imaging modalities are used for this purpose [1]. However, surgery-related foreign body granulomas can mimic tumors on imaging studies and can therefore mislead clinicians into applying unnecessary interventions [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Suture granuloma mimicking local recurrence of colon cancer after open right hemicolectomy: a case report

2021

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Background Foreign body granuloma is a rare surgery-related complication that can masquerade as cancer recurrence during postoperative surveillance. It may therefore deceive clinicians and lead to unnecessary interventions. The case presented herein demonstrates how a foreign body granuloma can be misleading in preoperative radiological studies and why this condition should not be ignored in differential diagnoses during surveillance of patients with previous history of abdominal surgery of any kind. Case presentation We report a case of suture granuloma mistaken for recurrent colon cancer, including the clinical history, imaging data, and histopathological photographs. A 60-year-old man was followed up at our institution after open right hemicolectomy 2 years earlier for ascending colon carcinoma. Contrast-enhanced computed tomography and magnetic resonance imaging revealed an infiltrative heterogeneous soft tissue lesion at the right mesenteric root, adjacent to the ileocolic anastomosis. Local recurrence was therefore suspected. We performed exploratory laparotomy, excised the tumor, and sent it for histopathological examination, which confirmed suture granuloma. Conclusions Foreign body granuloma is a rare surgery-related complication that should be considered during surveillance following colectomy. Its radiological features may mimic recurrent lesions, thus misleading clinicians and causing unnecessary interventions or further complications.

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Intra-abdominal suture granulomas masquerading as colon carcinoma: a case report

Cited by 5 publications

References 26 publications

Suture granuloma masquerading as primary ovarian malignancy: a case report

Suture granuloma masquerading as primary ovarian malignancy: a case report

Differenciáldiagnosztikai nehézséget okozó fonálgranuloma appendectomia után

Suture granuloma mimicking local recurrence of colon cancer after open right hemicolectomy: a case report

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