BioGlue-induced inflammatory reaction mimicking oncologic recurrence in head and neck surgery: a case report

BioGlue is an albumin-glutaraldehyde surgical sealant approved by the Food and Drug Administration that is widely used across multiple surgical specialties for more than two decades. We report an unusual case in which the application of BioGlue during a cervical lymph node dissection resulted in a mass-forming inflammatory reaction that radiographically mimicked recurrent malignancy. The lesion demonstrated concerning features on CT, MRI, and PET-CT, prompting further evaluation with fine-needle aspiration and core needle biopsy, which revealed a granulomatous foreign-body reaction without evidence of malignancy. The patient was managed with observation, and surveillance imaging demonstrated stability without disease recurrence at 12 months. This case highlights an important diagnostic pitfall with significant implications for postoperative oncologic surveillance in head and neck surgery.