Abstract
IntroductionThis is the first case of suture granuloma mimicking isolated ovarian cancer relapse. Only six analogous cases have been previously reported in other malignancies.Case presentationWe report the case of a 44-year-old Caucasian woman with partially platinum-sensitive ovarian cancer in which radiological features, including computed tomography and combined 18F-fluorodeoxyglucose-positron emission tomography/computed tomography, were strongly suggestive of isolated cancer relapse in her right subdiaphragmatic region. Laparoscopic examination resulted negative, but was not completely suitable due to widespread adhesive syndrome. The laparotomy for secondary cytoreductive surgery and biopsy of the suspected area showed inflammatory granuloma caused by nonabsorbable propylene suture, without evidence of neoplastic cells. Moreover, unexpected peritoneal carcinosis was found.ConclusionsThis evidence suggests that clinical details about previous surgical procedures are necessary for adequate interpretation. Although much progress has been made in imaging techniques, especially in the promising field of combined 18F-fluorodeoxyglucose positron emission tomography/computed tomography, these procedures should be still thoroughly investigated in order to promptly rule out tumor recurrence and avoid unnecessary surgery.
Highlights
This is the first case of suture granuloma mimicking isolated ovarian cancer relapse
This evidence suggests that clinical details about previous surgical procedures are necessary for adequate interpretation
Much progress has been made in imaging techniques, especially in the promising field of combined 18F-fluorodeoxyglucose positron emission tomography/computed tomography, these procedures should be still thoroughly investigated in order to promptly rule out tumor recurrence and avoid unnecessary surgery
Summary
This case suggests that the occurrence of granuloma from a foreign body can induce false-positive imaging of recurrence. PET/CT is a useful innovative diagnostic modality in finding neoplastic lesions such as recurrence of ovarian cancer, it is still burdened by false positives and low sensitivity, as demonstrated in the present case. LV, LDF and EB participated in the design of the study and helped to draft the manuscript. AM participated in the design of the study and helped to draft the manuscript.
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