Suture granuloma masquerading as primary ovarian malignancy: a case report

Suture granuloma is an uncommon surgical complication comprising of foreign body granulomatous tissue reaction against the suture material. We present a case of ovarian suture granulomas in a 28-year-old female who was clinico-radiologically misdiagnosed as ovarian carcinoma. She presented with intermittent pelvic pain, on and off low-grade fever and menstrual irregularities for 6 months and had undergone laparoscopic tubectomy two years back. Ultrasonographic findings were suspicious of left ovarian malignancy. CA-125 levels were elevated (115 U/mL). Left oophoro-salpingectomy was performed and histopathological examination revealed multiple suture-related granulomas.

A Case of Rectal Suture Granuloma that was Suspected to be a Recurrent Rectal Carcinoma / 대한소화기내시경학회지

Suture granuloma is a benign, rare complication of surgical intervention and it is known to occur after the use of non-absorbable suture materials deep within the skin. Although suture granuloma can occur anywhere in the body after a variety of operations, its incidence has rapidly diminished in recent years since the widespread use of absorbable suture materials. Clinically, making the differential diagnosis with recurrent cancer is obviously important for a cancer patient because postoperative suture granuloma can mimic local tumor recurrence after surgical resection. We recently encountered a case of rectal suture granuloma in a patient with rectal cancer and who underwent low anterior resection 4 years previously. The diagnosis was made according to the characteristic image findings of endoscopic ultrasonography and the abdominal CT scan. The patient was successfully treated with broad-spectrum antibiotics, US-guided incision and drainage. We report here on a rare case of rectal suture granuloma and we briefly review the relevant literature.

A Case of Gastric Suture Granuloma Suspected of Malignant Submucosal Tumor / 대한소화기내시경학회지

A gastric suture granuloma is an uncommon postsurgical complication. When nonabsorbable sutures are used, the inflammation can persist months after the original procedure with the subsequent formation of an abscess around the sutures surrounded by granulation tissue. Suture granulomas are usually asymptomatic, and have clinical importance as a differential diagnosis of a gastric submucosal tumor. The incidence of suture granuloma is low using absorbable sutures in gastrointestinal anastomosis. We report a case of a 70 year old man diagnosed with a suture granuloma. Approximately 30 years earlier, he underwent primary closure due to gastric ulcer perforation. When a gastroscopy was performed to assess upper abdominal soreness, it revealed a submucosal tumor that indicated a malignancy, which was diagnosed as a suture granuloma after surgery.