Polymer clip granuloma mimicking lymph node recurrence: a case report

Area of Science:

• Surgical pathology
• Gastrointestinal surgery
• Inflammatory reactions

Background:

• Foreign body granulomas are postoperative inflammatory responses to surgical materials.
• Traditionally, sutures were the primary cause of abdominal foreign body granulomas (suture granulomas).
• Intra-abdominal foreign body granulomas from polymer clips are infrequently reported.

Purpose of the Study:

• To present a case of intra-abdominal foreign body granuloma caused by polymer clips.
• To highlight polymer clips as a potential cause of postoperative granulomatous reactions.
• To differentiate polymer clip granulomas from lymph node recurrence.

Main Methods:

• Case report of a 45-year-old woman post-laparoscopic sigmoid colon cancer resection.
• Follow-up imaging revealed an enlarging mass suspicious for lymph node recurrence.
• Laparoscopic resection confirmed a foreign body granuloma in response to polymer clips.

Main Results:

• A foreign body granuloma was identified.
• The granuloma was formed in response to nonabsorbable polymer clips used during the initial surgery.
• The granuloma mimicked lymph node recurrence on imaging.

Conclusions:

• Nonabsorbable polymer clips can induce postoperative granulomatous reactions.
• Foreign body granulomas from polymer clips may be misdiagnosed as lymph node recurrence.
• This case expands the understanding of causes for intra-abdominal foreign body granulomas.