Reaction to a surgical implant foreign body masquerading as recurrent uterine sarcoma

Obstet Gynecol. 2011 Feb;117(2 Pt 2):450-452. doi: 10.1097/AOG.0b013e3181f70bf0.

Abstract

Background: Multiple products to prevent adhesions or lessen the risk of soft tissue attachments are commercially available. The long-term nature of these products is unknown, and they may cause foreign body reactions masquerading as recurrent disease in patients with cancer.

Case: A perimenopausal female underwent a hysterectomy and placement of a surgical implant, polylactic acid. Final pathology revealed stage IA low-grade endometrial stromal sarcoma. Areas suspicious for recurrence were noted on radiographic imaging 1 year later, resulting in exploratory surgery. The suspicious areas were found to be foreign body reactions. Mass spectrometry identified the main component of the reactions as polylactic acid.

Conclusion: Adhesion barriers and other surgical implants may not always be completely metabolized and should be used with caution in patients with cancer.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis
  • Endometrial Neoplasms / diagnosis*
  • Female
  • Foreign-Body Reaction / diagnosis*
  • Foreign-Body Reaction / etiology
  • Foreign-Body Reaction / pathology
  • Foreign-Body Reaction / surgery
  • Humans
  • Lactic Acid / administration & dosage
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Pelvic Pain / diagnosis
  • Polyesters
  • Polymers / administration & dosage
  • Prostheses and Implants / adverse effects*
  • Sarcoma, Endometrial Stromal / diagnosis*
  • Sarcoma, Endometrial Stromal / etiology*
  • Tissue Adhesions / diagnosis
  • Tissue Adhesions / pathology
  • Tissue Adhesions / surgery

Substances

  • Polyesters
  • Polymers
  • Lactic Acid
  • poly(lactide)