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速即纱肉芽肿:肾细胞癌腹腔镜肾部分切除术治疗后“复发性”肿块病变的不常见原因。

Surgicel granuloma: unusual cause of "recurrent" mass lesion after laparoscopic nephron-sparing surgery for renal cell carcinoma.

机构信息

Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Urology. 2010 Aug;76(2):334-5. doi: 10.1016/j.urology.2009.06.070. Epub 2010 May 21.

Abstract

We present the first clinical report of Surgicel granuloma after laparoscopic nephron-sparing surgery and present the characteristics of this radiological image mimicking local recurrence. A 47-year-old man underwent laparoscopic nephron-sparing surgery for left renal interpolar incidentaloma; Surgicel bolsters were used for hemostasis. Histological examination revealed conventional clear-cell renal cell carcinoma with negative surgical margins. Magnetic resonance imaging at 3 months revealed a 2.5-cm enhancing mass in the region of nephron-sparing surgery. Computed tomography-guided core biopsy revealed foreign-body granuloma. Serial magnetic resonance imaging showed a decrease in the size/enhancement of the lesion during 12 months. To conclude, Surgicel may invoke foreign-body reaction leading to formation of pseudotumor, which leads to diagnostic dilemma.

摘要

我们报告首例腹腔镜肾部分切除术后 Surgicel 肉芽肿,并呈现出这种影像学表现酷似局部复发的特征。一名 47 岁男性因左肾极部偶发肿瘤行腹腔镜肾部分切除术,术中使用 Surgicel 止血。组织学检查显示常规的透明细胞肾细胞癌且切缘阴性。术后 3 个月磁共振成像显示肾部分切除部位有 2.5cm 增强肿块。CT 引导下的核心活检显示异物肉芽肿。连续磁共振成像显示 12 个月期间病变大小/增强程度减小。总之,Surgicel 可能引发异物反应,导致假性肿瘤形成,从而造成诊断困境。

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