Ura Ayato, Shimada Yoshifumi, Homma Takahiro, Tanabe Keitaro, Tsuchiya Tomoshi
Department of Thoracic Surgery, University of Toyama, Toyama, Toyama, Japan.
Division of Thoracic Surgery, Kurobe City Hospital, Kurobe, Toyama, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0234. Epub 2025 Jul 1.
A staple line granuloma (SG) in the lung, which arises adjacent to a staple line after lung surgery, is often difficult to differentiate from a stump recurrence. We report two cases of lung tumors that were suspected of being SGs, and the tumors resolved after the use of oral tranilast.
Case 1 is a 71-year-old woman who underwent a right S8 segmentectomy for lung adenocarcinoma (pT1miN0M0, stage IA1). A follow-up chest computed tomography (CT) scan, which was performed 9 months after surgery, revealed a mass adjacent to the staple line. The lesion disappeared by the 3rd month after administration of tranilast with no recurrence. Case 2 is a 70-year-old woman who underwent wedge resection for metastatic lung cancer originating from renal cancer. A follow-up chest CT scan, which we obtained 8 months after surgery, revealed a nodule adjacent to the staple line. The lesion disappeared by the 4th month after administration of tranilast with no recurrence.
Administration of tranilast can be a safe and effective diagnostic treatment for SG, when the treatment is performed with strict imaging follow-up and histologic biopsy in mind.
肺内吻合钉线肉芽肿（SG）在肺手术后出现在吻合钉线附近，通常难以与残端复发相鉴别。我们报告两例疑似为SG的肺肿瘤病例，在使用口服曲尼司特后肿瘤消退。
病例1是一名71岁女性，因肺腺癌（pT1miN0M0，IA1期）接受了右S8段切除术。术后9个月进行的胸部计算机断层扫描（CT）随访显示吻合钉线附近有一个肿块。在服用曲尼司特后第3个月病变消失，无复发。病例2是一名70岁女性，因源自肾癌的转移性肺癌接受了楔形切除术。术后8个月进行的胸部CT随访显示吻合钉线附近有一个结节。在服用曲尼司特后第4个月病变消失，无复发。
在严格的影像学随访和组织学活检的情况下，使用曲尼司特治疗SG是一种安全有效的诊断性治疗方法。
