Recently, iatrogenic foreign-body granuloma has been increasingly reported.
The asymptomatic presentation and confusing appearance of granuloma can lead to misdiagnosis of a secondary malignancy, especially for a patient with a corresponding past medical history. Sometimes, surgical treatment is unavoidable, and the diagnosis relies upon the pathologic result. Herein, we report an unusual case of a 43-year-old man who underwent a nephrectomy for renal cell carcinoma (clear cell type) 5 years ago. A secondary granuloma was identified behind the inferior vena cava in the retroperitoneum 6 months after the surgery, but the radiologists had failed to identify it throughout the 4 years of routine examination. Later on, the lesion was identified by positron emission tomography, which classified it as a highly 18F-fluorodeoxyglucose-avid lesion. Considering no visible foreign-bodies identified on images, the lesion was arguably diagnosed as a lymph node metastasis of renal cancer. Finally, it was confirmed as a foreign-body granuloma encasing surgical suture and adipose tissue by the pathological analysis.
Written by:
Luo J, Mao Y, Cai S, Shen X, Chen S, Xie L. Are you the author?
Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China; Department of Radiology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
Reference: Onco Targets Ther. 2014 Nov 20;7:2137-41.
doi: 10.2147/OTT.S70705
PubMed Abstract
PMID: 25429231