Suture Granuloma With False-Positive Findings on FDG-PET/CT Resected via Laparoscopic Surgery

Int Surg. 2015 Apr;100(4):604-7. doi: 10.9738/INTSURG-D-14-00140.1.

Abstract

A 61-year-old woman who had undergone total hysterectomy 16 years previously exhibited a pelvic tumor on computed tomography (CT). F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/CT imaging revealed a solitary small focus of increased FDG activity in the pelvis. A gastrointestinal stromal tumor originating in the small intestine or another type of tumor originating in the mesentery (desmoid, schwannoma, or foreign body granuloma) was suspected; therefore, laparoscopic resection was conducted. A white, hard tumor was found to originate from the mesentery of the sigmoid colon and adhered slightly to the small intestine. The tumor was resected with a negative margin, and the pathologic diagnosis was suture granuloma. The possibility of suture granuloma should be kept in mind in cases of tumors with positive PET findings and a history of surgery close to the lesion. However, it is difficult to preoperatively diagnose pelvic tumors using a biopsy. Therefore, considering the possibility of malignancy, it is necessary to achieve complete resection without exposing the tumor.

Keywords: Laparoscopy; Positron emission tomography (PET); Suture granuloma.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • False Positive Reactions
  • Female
  • Fluorodeoxyglucose F18
  • Granuloma / diagnosis
  • Granuloma / surgery*
  • Humans
  • Hysterectomy
  • Laparoscopy*
  • Middle Aged
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Sigmoid Diseases / diagnosis
  • Sigmoid Diseases / surgery*
  • Sutures / adverse effects*
  • Tomography, X-Ray Computed

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18