Suture Granuloma Showing False-Positive Findings on FDG-PET.

Area of Science:

• Oncology
• Nuclear Medicine
• Surgical Pathology

Background:

• Mixed germ-cell testicular tumors require careful postoperative monitoring.
• Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) is a common imaging modality for detecting cancer recurrence.
• Suture materials can elicit inflammatory responses, potentially mimicking disease on imaging.

Purpose of the Study:

• To report a case of suture granuloma causing a false-positive FDG-PET finding after testicular tumor surgery.
• To review the literature on suture granulomas and their impact on FDG-PET interpretation.
• To highlight the importance of considering suture reactivity in postoperative imaging.

Main Methods:

• Case presentation of a 33-year-old male with mixed germ-cell testicular tumor.
• Postoperative FDG-PET imaging.
• Review of existing literature on suture granulomas and FDG-PET findings.

Main Results:

• FDG-PET revealed increased FDG uptake in the left inguinal area.
• This uptake was identified as a suture reactivity granuloma, not metastasis or local recurrence.
• Literature review confirmed suture granulomas as a cause of false-positive FDG-PET results.

Conclusions:

• Suture granulomas can lead to false-positive findings on postoperative FDG-PET scans.
• The use of silk thread may contribute to suture reactivity granulomas.
• Avoiding silk sutures could prevent unnecessary interventions in patients monitored with FDG-PET.