Suture granuloma: a rare differential diagnosis of residual/recurrent gastrointestinal stromal tumor of stomach

Abstract

In the present era of modern surgical practice, the incidence of intra-abdominal suture granuloma is extremely rare with reduced use of non-absorbable silk sutures and even rarer following laparoscopic procedures. We report herein a case of silk granuloma presenting as large submucosal polypoidal lesion in a recently operated case of gastrointestinal stromal tumor (GIST) of stomach. Though endoscopic biopsy showed chronic non-specific gastritis with no evidence of malignancy, our patient underwent excision of lesion due to high likelihood of neoplastic lesion suggested by radiological evaluation and recent history of surgery for GIST but histopathology surprisingly showed Giant cell silk granuloma. In summary, the possibility of suture granulomas should always be considered while evaluating postoperative CT scan/PET scan for a mass lesion at operated site, particularly in patients who have undergone surgery with non-absorbable silk sutures.