A Case of Intracerebral Inflammatory Granuloma around an Absorbable Gelatin Sponge

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  • Fueki Yohei
    Department of Neurosurgery, Yamaguchi University
  • Oguma Hirofumi
    Department of Neurosurgery, Jichi Medical University
  • Gomi Akira
    Department of Pediatric Neurosurgery, Jichi Children's Medical Center Tochigi, Jichi Medical University
  • Kawai Kensuke
    Department of Neurosurgery, Jichi Medical University

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Other Title
  • 脳内に留置した吸収性ゼラチンスポンジ周囲に生じた肉芽腫の1例
  • ノウナイ ニ リュウチ シタ キュウシュウセイ ゼラチンスポンジ シュウイ ニ ショウジタ ニクゲシュ ノ 1レイ

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Abstract

<p>  Various surgical materials are routinely used for hemostasis, dural closure, or cranioplasty. However, such substances have sometimes been reported to cause granulomas. We experienced a case of granuloma that developed at the placement site of an absorbable gelatin sponge. A 15-year-old male underwent neuroendoscopic biopsy via the right anterior horn of the lateral ventricle for a pineal tumor. An absorbable gelatin sponge was placed at the endoscopy tract after removal of the sheath. The pathological diagnosis was a mixed germ cell tumor, which was surgically resected and treated with radiochemotherapy. Follow-up MR imaging demonstrated a gadrinium-enhanced lesion along the endoscopic tract in the right frontal lobe, which emerged as a residual gelatin sponge and surrounding inflammation as a result of the patient's third surgery. We speculated that impaired absorption due to radiochemotherapy and excessive immune response due to his allergic predisposition may be attributed to the granuloma formation in this case.</p>

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