Foreign Body Granuloma

Penetration of foreign bodies may present a diagnostic challenge to the surgeon. The foreign body granuloma is a biological response of tissue to any foreign body in the tissue. The pathway of arriving to the diagnosis of foreign body granuloma becomes difficult when patient presents with non specific symptoms such as pain/ swelling, and in history- no recollection of previous trauma. It can be of two types- a) Iatrogenic gossypiboma by retained surgical sponge intra-operatively b) Granulation by a penetrating foreign body such as wooden splinter or other materials. -The most frequent reported injury is to hand, thigh, knee and feet; these may be limited to soft tissue of may be intra articular. The time and type of presentation varies according to the immune status of the individual. In cases, where history of trauma is uncertain, the presentation is very late and the radiographic appearance may be confusing - Median time of presentation: 4 months to 20 years

Suture granuloma mimicking local recurrence of colon cancer after open right hemicolectomy: a case report

Background Foreign body granuloma is a rare surgery-related complication that can masquerade as cancer recurrence during postoperative surveillance. It may therefore deceive clinicians and lead to unnecessary interventions. The case presented herein demonstrates how a foreign body granuloma can be misleading in preoperative radiological studies and why this condition should not be ignored in differential diagnoses during surveillance of patients with previous history of abdominal surgery of any kind. Case presentation We report a case of suture granuloma mistaken for recurrent colon cancer, including the clinical history, imaging data, and histopathological photographs. A 60-year-old man was followed up at our institution after open right hemicolectomy 2 years earlier for ascending colon carcinoma. Contrast-enhanced computed tomography and magnetic resonance imaging revealed an infiltrative heterogeneous soft tissue lesion at the right mesenteric root, adjacent to the ileocolic anastomosis. Local recurrence was therefore suspected. We performed exploratory laparotomy, excised the tumor, and sent it for histopathological examination, which confirmed suture granuloma. Conclusions Foreign body granuloma is a rare surgery-related complication that should be considered during surveillance following colectomy. Its radiological features may mimic recurrent lesions, thus misleading clinicians and causing unnecessary interventions or further complications.