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J Korean Surg Soc. 2007 Mar;72(3):239-243. Korean. Case Report.
Suh YS , Park DJ , Kim HH , Han HS , Lee HJ , Yang HK , Lee KU .
Department of Surgery, Seoul National University College of Medicine, Korea.
Department of Surgery, Seoul National University Bundang Hospital, Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

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.

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