A Case of Foreign Body Granuloma Due to the Presence of a Silk Surgical Thread after Resection of Local Recurrence of Descending Colon Cancer

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  • 下行結腸癌局所再発術後にFDG-PET/CT陽性であった縫合糸による異物性肉芽腫の1例

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Abstract

<p>We report the case of a 62-year-old woman who underwent laparoscopic left hemicolectomy for descending colon cancer. The histopathological diagnosis was pT3pN0pM0, pStage IIa. After 22 months, the serum carcinoembryonic antigen (CEA) level increased. FDG-PET/CT showed a mass around the anastomosis and intense FDG uptake in this region (maximum standardized uptake value [SUVmax]: 5.5). Local recurrence of colon cancer was suspected; therefore, we performed resection of the colon with the tumor. The histopathological diagnosis was well-differentiated adenocarcinoma and local recurrence of colon cancer. Twelve months after this surgery, abdominal enhanced CT showed a mass around the anastomosis and FDG-PET/CT showed intense FDG uptake in the same region (SUVmax: 9.7). Recurrence of colon cancer was once again suspected and surgical resection was performed. During the surgery, a mass was found in the mesentery of the colon anastomosis and had infiltrated into the small intestine. We resected part of the colon with the anastomosis, tumor and small intestine. Histopathological examination revealed a silk thread surrounded by inflammatory cells, but no malignant cells. This led to diagnosis of foreign body granuloma due to a surgical thread. This is the first report of a foreign body granuloma after local recurrence of colon cancer. The case shows the importance of considering foreign body granuloma in similar cases with positive findings on FDG-PET/CT.</p>

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