Limits...
A retained plastic protective cover mimicking malignancy: Case report.

Ozsoy M, Celep B, Ozsan I, Bal A, Ozkececi ZT, Arikan Y - Int J Surg Case Rep (2013)

Bottom Line: Retroperitoneal lymph node dissection was performed.There were no malignant cells in the histopathological examination of the surgical specimen.These granulomas may cause confusion during patient follow-up, especially in those who have undergone major abdominal surgery due to cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Afyon Kocatepe University, Afyon, Turkey. Electronic address: dr.mustafaozsoy@gmail.com.

No MeSH data available.


Related in: MedlinePlus

Operation field after resection and periaortic-pericaval lymph node dissection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3860039&req=5

fig0020: Operation field after resection and periaortic-pericaval lymph node dissection.

Mentions: A 60-year-old man presented with abdominal cramps and right sided back pain. He had undergone a laparoscopic right radical nephrectomy for renal cell carcinoma 5 years earlier. His family history was nonspecific. Physical examination and routine blood tests were normal. Abdominal ultrasonography was nonspecific, while abdominal tomography revealed a mass surrounding the main vascular structures with malignant features in the location of previously nephrectomy (Fig. 1). Magnetic resonance imaging results were similar to abdominal tomography. We decided to use positron emission tomography (PET/CT) to determine whether the mass was malignant or benign (Fig. 2). The mass was deemed to be malignant due to increased metabolic activity with a suv max of 10.3 (normal value < 5), and surgical intervention was deemed appropriate for an apparent local recurrence of renal cell carcinoma (Fig. 3). During the operation, dense adhesions were encountered between the ascending colon and the retroperitoneum. The right colon and duodenum were dissected from the retroperitoneum. A firm mass was detected with irregular borders surrounding the inferior vena cava and aorta. Dissection began from the distal to the proximal part of the mass. Retroperitoneal lymph node dissection including the periaortic and pericaval lymph nodes was performed. The region of previous operation was also included in the dissection (Fig. 4). The resected specimen was opened and unintentionally retained plastic foreign bodies were found (Fig. 5A). Detailed analysis of the patient's previous operative note and the hospital bill showed that an endovascular stapler [45 mm articulating vascular stapler (Ethicon Endosurgery, CA)] had been used for vascular control (Fig. 5B). We matched the specimen and the endovascular stapler and recognized that the foreign bodies exactly resembled the plastic protective cover of the vascular stapler. There were no malignant cells in the histopathological examination of the surgical specimen.


A retained plastic protective cover mimicking malignancy: Case report.

Ozsoy M, Celep B, Ozsan I, Bal A, Ozkececi ZT, Arikan Y - Int J Surg Case Rep (2013)

Operation field after resection and periaortic-pericaval lymph node dissection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860039&req=5

fig0020: Operation field after resection and periaortic-pericaval lymph node dissection.
Mentions: A 60-year-old man presented with abdominal cramps and right sided back pain. He had undergone a laparoscopic right radical nephrectomy for renal cell carcinoma 5 years earlier. His family history was nonspecific. Physical examination and routine blood tests were normal. Abdominal ultrasonography was nonspecific, while abdominal tomography revealed a mass surrounding the main vascular structures with malignant features in the location of previously nephrectomy (Fig. 1). Magnetic resonance imaging results were similar to abdominal tomography. We decided to use positron emission tomography (PET/CT) to determine whether the mass was malignant or benign (Fig. 2). The mass was deemed to be malignant due to increased metabolic activity with a suv max of 10.3 (normal value < 5), and surgical intervention was deemed appropriate for an apparent local recurrence of renal cell carcinoma (Fig. 3). During the operation, dense adhesions were encountered between the ascending colon and the retroperitoneum. The right colon and duodenum were dissected from the retroperitoneum. A firm mass was detected with irregular borders surrounding the inferior vena cava and aorta. Dissection began from the distal to the proximal part of the mass. Retroperitoneal lymph node dissection including the periaortic and pericaval lymph nodes was performed. The region of previous operation was also included in the dissection (Fig. 4). The resected specimen was opened and unintentionally retained plastic foreign bodies were found (Fig. 5A). Detailed analysis of the patient's previous operative note and the hospital bill showed that an endovascular stapler [45 mm articulating vascular stapler (Ethicon Endosurgery, CA)] had been used for vascular control (Fig. 5B). We matched the specimen and the endovascular stapler and recognized that the foreign bodies exactly resembled the plastic protective cover of the vascular stapler. There were no malignant cells in the histopathological examination of the surgical specimen.

Bottom Line: Retroperitoneal lymph node dissection was performed.There were no malignant cells in the histopathological examination of the surgical specimen.These granulomas may cause confusion during patient follow-up, especially in those who have undergone major abdominal surgery due to cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Afyon Kocatepe University, Afyon, Turkey. Electronic address: dr.mustafaozsoy@gmail.com.

No MeSH data available.


Related in: MedlinePlus