Djafari Anahita Ansari, Samenezhad Sina, Hojjati Seyyed Ali, Rakhsha Azadeh, Rafighi Dorna
Urology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Surg Case Rep. 2025 Oct;135:111774. doi: 10.1016/j.ijscr.2025.111774. Epub 2025 Aug 12.
Partial nephrectomy is the standard treatment for localized renal cell carcinoma, often using oxidized cellulose (Surgicel®) for hemostasis. Retained Surgicel® may mimic tumor recurrence on imaging, posing a critical diagnostic challenge with potential for unnecessary interventions.
We report a 54-year-old female with chromophobe renal cell carcinoma who underwent open partial nephrectomy with Surgicel® placement. Two years later, imaging revealed a suspicious renal mass suggesting tumor recurrence. Surgical excision and histopathology identified a foreign body granulomatous reaction to retained Surgicel®, with no malignancy detected.
Surgicel® typically resorbs within weeks but can occasionally cause granulomatous reactions appearing as enhancing masses with diffusion restriction on MRI, mimicking malignancy. Awareness of this entity and correlation with surgical history are essential. T2-weighted MRI assists differentiation, and biopsy confirms diagnosis, preventing unnecessary surgery.
Retained Surgicel® is a rare but important cause of false-positive tumor recurrence after partial nephrectomy. Accurate diagnosis through imaging, clinical correlation, and multidisciplinary communication can avoid misdiagnosis and unwarranted invasive procedures.
部分肾切除术是局限性肾细胞癌的标准治疗方法，常使用氧化纤维素（ Surgicel®）进行止血。残留的 Surgicel®在影像学上可能类似肿瘤复发，对诊断构成关键挑战，并可能导致不必要的干预。
我们报告一例54岁患有嫌色性肾细胞癌的女性患者，其接受了使用 Surgicel®的开放性部分肾切除术。两年后，影像学检查发现一个可疑的肾脏肿块，提示肿瘤复发。手术切除及组织病理学检查发现对残留的 Surgicel®存在异物肉芽肿反应，未检测到恶性肿瘤。
Surgicel®通常在数周内吸收，但偶尔可引起肉芽肿反应，在MRI上表现为强化肿块且有扩散受限，类似恶性肿瘤。认识到这一实体并与手术史相关联至关重要。T2加权MRI有助于鉴别，活检可确诊，从而避免不必要的手术。
残留的 Surgicel®是部分肾切除术后肿瘤复发假阳性的罕见但重要原因。通过影像学、临床关联及多学科沟通进行准确诊断，可避免误诊和不必要的侵入性操作。
