SURGICEL mimicking a recurrence of a temporomandibular joint chondrosarcoma

The hemostatic agents have increased the bleeding complication in many surgeries. The SURGICEL is a preparation of oxidized cellulose regenerated from alpha-cellulose in an organic solvent, this product has the characteristic of resorbing without having a reaction of foreign body in 4-8 weeks.

We report the case of a patient operated on for a chondrosarcoma of the right temporomandibular joint with normal postoperative consequences, nevertheless after 3 months, the patient consulted again for the same symptomatology. To rule out tumor recurrence, magnetic resonance imaging has been requested; which showed a lesion well limited in T1 hypointense and heterogeneous in T2. During the surgical revision, we discover the presence of a reworked fibrous material, this material was the surgicel used for hemostatic purposes during the first surgery.

Hemostatic agents significantly reduced bleeding complications. But some authors are observed that some substances can persisted after 8 weeks of using, clinical manifestations depend of operative site. The diagnosis is suspected behind an imaging resonance aspect of a lesion well limited in T1 hypointense and heterogeneous in T2, but the discovery of a reworked fibrous materiel when the revision can confirm it.

the absence of degradation of the surgicel can clinically mimic a superinfection or even tumor recurrence; imaging guide the diagnosis but only the surgical revision can confirm it.