Oxidized regenerated cellulose granuloma mimicking recurrent mass lesion after laparoscopic nephron sparing surgery

Tzevat Tefik, Oner Sanli, Tayfun Oktar, Omer Baris Yucel, Yasemin Ozluk, Isin Kilicaslan

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

INTRODUCTION: Achieving hemostasis in laparoscopic nephron sparing surgery (LNSS), a technically demanding procedure, is challenging. Absorbable hemostatic agents, such as oxidized regenerated cellulose (ORC) are frequently used for hemostasis in laparoscopic nephron sparing surgery. Retention of this material is a very rare situation. PRESENTATION OF THE CASE: We are presenting a case of ORC granuloma after nephron sparing surgery for renal cell carcinoma (RCC) mimicking recurrent renal mass. A 50-year-old woman diagnosed with upper pole renal mass underwent laparoscopic nephron sparing surgery. Oxidized regenerated cellulose was used to achieve hemostasis for an oozing from the perirenal tissue. Resection confirmed RCC. Imaging at 6th month follow-up revealed a lesion with contrast enhancement at the location of the adrenal gland. Positron emission tomography suggested inflammation or metastasis. Histopathological evaluation of the mass revealed foreign body granuloma. DISCUSSION: Laparoscopic nephron sparing surgery is becoming a standardized treatment of select renal tumors. Hemostatic agents, such as ORC, are frequently used to minimize complications in LNSS. In case of ORC application, which is completely absorbed in 8 weeks, to or to a location with close proximity to the primary resection site, surgical granuloma formation should be considered. However its use should not be discouraged and biopsy may be considered for definitive diagnosis. CONCLUSION: Oxidized regenerated cellulose granuloma may mimic different entities such as including invasive carcinoma. Thus it is of utmost importance, if ORC was used during LNSS, the location and use of this material should be noted precisely.

Original languageEnglish (US)
Pages (from-to)227-230
Number of pages4
JournalInternational Journal of Surgery Case Reports
Volume3
Issue number6
DOIs
StatePublished - Jan 1 2012

Fingerprint

oxidized cellulose
Nephrons
Granuloma
Hemostasis
Hemostatics
Kidney
Renal Cell Carcinoma
Foreign-Body Granuloma
Adrenal Glands
Positron-Emission Tomography
Neoplasm Metastasis
Inflammation
Carcinoma
Biopsy

Keywords

  • Laparoscopic nephron sparing surgery
  • Oxidized regenerated cellulose granuloma
  • Recurrent renal mass
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Surgery

Cite this

Oxidized regenerated cellulose granuloma mimicking recurrent mass lesion after laparoscopic nephron sparing surgery. / Tefik, Tzevat; Sanli, Oner; Oktar, Tayfun; Yucel, Omer Baris; Ozluk, Yasemin; Kilicaslan, Isin.

In: International Journal of Surgery Case Reports, Vol. 3, No. 6, 01.01.2012, p. 227-230.

Research output: Contribution to journalArticle

Tefik, Tzevat ; Sanli, Oner ; Oktar, Tayfun ; Yucel, Omer Baris ; Ozluk, Yasemin ; Kilicaslan, Isin. / Oxidized regenerated cellulose granuloma mimicking recurrent mass lesion after laparoscopic nephron sparing surgery. In: International Journal of Surgery Case Reports. 2012 ; Vol. 3, No. 6. pp. 227-230.
@article{ecc07bac33c5431fad5fc54dd30a25bd,
title = "Oxidized regenerated cellulose granuloma mimicking recurrent mass lesion after laparoscopic nephron sparing surgery",
abstract = "INTRODUCTION: Achieving hemostasis in laparoscopic nephron sparing surgery (LNSS), a technically demanding procedure, is challenging. Absorbable hemostatic agents, such as oxidized regenerated cellulose (ORC) are frequently used for hemostasis in laparoscopic nephron sparing surgery. Retention of this material is a very rare situation. PRESENTATION OF THE CASE: We are presenting a case of ORC granuloma after nephron sparing surgery for renal cell carcinoma (RCC) mimicking recurrent renal mass. A 50-year-old woman diagnosed with upper pole renal mass underwent laparoscopic nephron sparing surgery. Oxidized regenerated cellulose was used to achieve hemostasis for an oozing from the perirenal tissue. Resection confirmed RCC. Imaging at 6th month follow-up revealed a lesion with contrast enhancement at the location of the adrenal gland. Positron emission tomography suggested inflammation or metastasis. Histopathological evaluation of the mass revealed foreign body granuloma. DISCUSSION: Laparoscopic nephron sparing surgery is becoming a standardized treatment of select renal tumors. Hemostatic agents, such as ORC, are frequently used to minimize complications in LNSS. In case of ORC application, which is completely absorbed in 8 weeks, to or to a location with close proximity to the primary resection site, surgical granuloma formation should be considered. However its use should not be discouraged and biopsy may be considered for definitive diagnosis. CONCLUSION: Oxidized regenerated cellulose granuloma may mimic different entities such as including invasive carcinoma. Thus it is of utmost importance, if ORC was used during LNSS, the location and use of this material should be noted precisely.",
keywords = "Laparoscopic nephron sparing surgery, Oxidized regenerated cellulose granuloma, Recurrent renal mass, Renal cell carcinoma",
author = "Tzevat Tefik and Oner Sanli and Tayfun Oktar and Yucel, {Omer Baris} and Yasemin Ozluk and Isin Kilicaslan",
year = "2012",
month = "1",
day = "1",
doi = "10.1016/j.ijscr.2012.03.001",
language = "English (US)",
volume = "3",
pages = "227--230",
journal = "International Journal of Surgery Case Reports",
issn = "2210-2612",
publisher = "Elsevier BV",
number = "6",

}

TY - JOUR

T1 - Oxidized regenerated cellulose granuloma mimicking recurrent mass lesion after laparoscopic nephron sparing surgery

AU - Tefik, Tzevat

AU - Sanli, Oner

AU - Oktar, Tayfun

AU - Yucel, Omer Baris

AU - Ozluk, Yasemin

AU - Kilicaslan, Isin

PY - 2012/1/1

Y1 - 2012/1/1

N2 - INTRODUCTION: Achieving hemostasis in laparoscopic nephron sparing surgery (LNSS), a technically demanding procedure, is challenging. Absorbable hemostatic agents, such as oxidized regenerated cellulose (ORC) are frequently used for hemostasis in laparoscopic nephron sparing surgery. Retention of this material is a very rare situation. PRESENTATION OF THE CASE: We are presenting a case of ORC granuloma after nephron sparing surgery for renal cell carcinoma (RCC) mimicking recurrent renal mass. A 50-year-old woman diagnosed with upper pole renal mass underwent laparoscopic nephron sparing surgery. Oxidized regenerated cellulose was used to achieve hemostasis for an oozing from the perirenal tissue. Resection confirmed RCC. Imaging at 6th month follow-up revealed a lesion with contrast enhancement at the location of the adrenal gland. Positron emission tomography suggested inflammation or metastasis. Histopathological evaluation of the mass revealed foreign body granuloma. DISCUSSION: Laparoscopic nephron sparing surgery is becoming a standardized treatment of select renal tumors. Hemostatic agents, such as ORC, are frequently used to minimize complications in LNSS. In case of ORC application, which is completely absorbed in 8 weeks, to or to a location with close proximity to the primary resection site, surgical granuloma formation should be considered. However its use should not be discouraged and biopsy may be considered for definitive diagnosis. CONCLUSION: Oxidized regenerated cellulose granuloma may mimic different entities such as including invasive carcinoma. Thus it is of utmost importance, if ORC was used during LNSS, the location and use of this material should be noted precisely.

AB - INTRODUCTION: Achieving hemostasis in laparoscopic nephron sparing surgery (LNSS), a technically demanding procedure, is challenging. Absorbable hemostatic agents, such as oxidized regenerated cellulose (ORC) are frequently used for hemostasis in laparoscopic nephron sparing surgery. Retention of this material is a very rare situation. PRESENTATION OF THE CASE: We are presenting a case of ORC granuloma after nephron sparing surgery for renal cell carcinoma (RCC) mimicking recurrent renal mass. A 50-year-old woman diagnosed with upper pole renal mass underwent laparoscopic nephron sparing surgery. Oxidized regenerated cellulose was used to achieve hemostasis for an oozing from the perirenal tissue. Resection confirmed RCC. Imaging at 6th month follow-up revealed a lesion with contrast enhancement at the location of the adrenal gland. Positron emission tomography suggested inflammation or metastasis. Histopathological evaluation of the mass revealed foreign body granuloma. DISCUSSION: Laparoscopic nephron sparing surgery is becoming a standardized treatment of select renal tumors. Hemostatic agents, such as ORC, are frequently used to minimize complications in LNSS. In case of ORC application, which is completely absorbed in 8 weeks, to or to a location with close proximity to the primary resection site, surgical granuloma formation should be considered. However its use should not be discouraged and biopsy may be considered for definitive diagnosis. CONCLUSION: Oxidized regenerated cellulose granuloma may mimic different entities such as including invasive carcinoma. Thus it is of utmost importance, if ORC was used during LNSS, the location and use of this material should be noted precisely.

KW - Laparoscopic nephron sparing surgery

KW - Oxidized regenerated cellulose granuloma

KW - Recurrent renal mass

KW - Renal cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=84862227574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862227574&partnerID=8YFLogxK

U2 - 10.1016/j.ijscr.2012.03.001

DO - 10.1016/j.ijscr.2012.03.001

M3 - Article

VL - 3

SP - 227

EP - 230

JO - International Journal of Surgery Case Reports

JF - International Journal of Surgery Case Reports

SN - 2210-2612

IS - 6

ER -