TY - JOUR
T1 - Silk suture granuloma with false-positive findings on PET/CT accompanied by peritoneal metastasis after colon cancer surgery
AU - Matsuura, Sohei
AU - Sasaki, Kazuhito
AU - Kawasaki, Hiroshi
AU - Abe, Hideki
AU - Nagai, Hideo
AU - Yoshimi, Fuyo
N1 - Publisher Copyright:
© 2016 The Author(s)
PY - 2016
Y1 - 2016
N2 - Introduction Suture granuloma is a rare benign tumor caused by suture material, which usually appears several months or years after surgery. Presentation of case A 71-year-old man underwent sigmoidectomy and partial hepatectomy (S6) for sigmoid colon cancer and synchronous liver metastasis at a previous hospital. At 4 postoperative months, surveillance computed tomography (CT) revealed a suspicious tumor at the hepatic resection stump. He was referred to our hospital for further examinations and treatments. Positron emission tomography/CT (PET/CT) revealed abnormal hepatic F-18 fluorodeoxyglucose (FDG) uptake below the diaphragm at the S5/S8 surface. Peritoneal metastasis was suspected and surgery was performed. White nodules were found in the Douglas pouch. A diagnosis of adenocarcinoma was confirmed by frozen section analysis of the nodules. He underwent a partial hepatectomy (S5/S8) and partial resection of the diaphragm. Pathological examination showed that the liver tumor was a foreign body granuloma that included silk suture material. Discussion Although postoperative PET/CT surveillance is useful following malignant tumor resection, it is important to note that PET/CT false-positive findings are possible. Furthermore, PET/CT cannot detect small peritoneal metastases, necessitating a thorough abdominal examination. Conclusion In cases of malignancy, the possibility of postoperative suture granuloma should be considered. In addition, a thorough surgical examination of the abdomen should be performed in cases of suspected recurrence.
AB - Introduction Suture granuloma is a rare benign tumor caused by suture material, which usually appears several months or years after surgery. Presentation of case A 71-year-old man underwent sigmoidectomy and partial hepatectomy (S6) for sigmoid colon cancer and synchronous liver metastasis at a previous hospital. At 4 postoperative months, surveillance computed tomography (CT) revealed a suspicious tumor at the hepatic resection stump. He was referred to our hospital for further examinations and treatments. Positron emission tomography/CT (PET/CT) revealed abnormal hepatic F-18 fluorodeoxyglucose (FDG) uptake below the diaphragm at the S5/S8 surface. Peritoneal metastasis was suspected and surgery was performed. White nodules were found in the Douglas pouch. A diagnosis of adenocarcinoma was confirmed by frozen section analysis of the nodules. He underwent a partial hepatectomy (S5/S8) and partial resection of the diaphragm. Pathological examination showed that the liver tumor was a foreign body granuloma that included silk suture material. Discussion Although postoperative PET/CT surveillance is useful following malignant tumor resection, it is important to note that PET/CT false-positive findings are possible. Furthermore, PET/CT cannot detect small peritoneal metastases, necessitating a thorough abdominal examination. Conclusion In cases of malignancy, the possibility of postoperative suture granuloma should be considered. In addition, a thorough surgical examination of the abdomen should be performed in cases of suspected recurrence.
UR - http://www.scopus.com/inward/record.url?scp=84988529990&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84988529990&partnerID=8YFLogxK
U2 - 10.1016/j.ijscr.2016.09.002
DO - 10.1016/j.ijscr.2016.09.002
M3 - Article
AN - SCOPUS:84988529990
SN - 2210-2612
VL - 28
SP - 22
EP - 25
JO - International Journal of Surgery Case Reports
JF - International Journal of Surgery Case Reports
ER -