J Korean Surg Soc.  2007 Mar;72(3):239-243.

Postoperative Foreign Body Granuloma, which was Overdiagnosed as a Metastatic Lymph Node: The Role of Laparoscopy and Laparoscopic Ultrasonography in the Evaluation of Metastatic Lesions

• Suh YS
• Park DJ
• Kim HH
• Han HS
• Lee HJ
• Yang HK
• Lee KU

Abstract

We report the case of a postoperative foreign body granuloma, which was misdiagnosed as a metastatic lymph node, but confirmed by laparoscopic removal. A-68-year old man was admitted for the management of a suspected metastatic lymph node. He had undergone a laparoscopy-assisted distal gastrectomy, with simultaneous D2 lymph node dissection and a left adrenalectomy for T1N0M0 early gastric cancer and an adrenal adenoma 8 months previously. Preoperative computed tomography and whole body PET showed a 1.6 cm sized suspected metastatic lymph node between the efferent jejunal loop and pancreas tail. A diagnostic laparoscopy was performed for pathological confirmation. After laparoscopic adhesiolysis, the lesion was localized using laparoscopic ultrasonography, with the mass also removed laparoscopically. Permanent pathology revealed the mass to be a foreign body granuloma, but without malignancy. In cases of suspected local recurrence or lymph node metastasis following radical surgery, a diagnostic laparoscopic procedure could play a role in confirming the recurrence.

Keyword

Diagnostic laparoscopy; Foreign body granuloma; Laparoscopic gastrectomy; Laparoscopic ultrasonography

MeSH Terms

Adenoma
Adrenalectomy
Foreign Bodies*
Gastrectomy
Granuloma, Foreign-Body*
Laparoscopy*
Lymph Node Excision
Lymph Nodes*
Neoplasm Metastasis
Pancreas
Pathology
Recurrence
Stomach Neoplasms
Ultrasonography*