Suture granulomas developing after the treatment of oral squamous cell carcinoma. (2018)

• Record Type: Journal Article
• Authors: Yoshioka, Yukio; Nakatao, Hirotaka; Hamana, Tomoaki; Hamada, Atsuko; Kanda, Taku; Koizumi, Koichi; Toratani, Shigeaki; Okamoto, Tetsuji
• Is Part Of: International journal of surgery case reports. Volume 50(2018)
• Page Start: 68
• Page End: 71
• Publication Date: 2018
• Subjects: CDDP cisplatin -- CT computed tomography -- US ultrasonography -- PET positron emission tomography; Suture granuloma -- Foreign body granuloma -- Absorbable sutures -- Chemoradiation -- Oral squamous cell carcinoma -- Neck dissection; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2018.07.021
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: A 64-year-old man underwent head and neck surgery for oral squamous cell carcinoma. Multiple suture granulomas mimicking tumor recurrence developed in the radiation field. The suture granulomas developed shortly after adjuvant chemoradiation therapy. Suspect suture granulomas when nodules appear during postoperative radiotherapy. Suture granulomas may show spontaneous resolution. Abstract: Introduction: Suture granuloma is a benign tumor that develops because of the presence of surgical suture materials. It commonly occurs several years after different types of surgeries. Here we report a case involving a 64-year-old man who underwent head and neck surgery for oral squamous cell carcinoma and developed multiple suture granulomas mimicking tumor recurrence in the radiation field just a few days after the completion of adjuvant chemoradiation therapy. Presentation of case: The patient underwent surgery for lymph node metastasis in the neck at 6 months after the resection of primary oral squamous cell carcinoma. Fifteen days after the completion of adjuvant chemoradiation therapy at a total dose of 50 Gy, small nodules appeared in the radiation field, along the areas of the subcutaneous surgical sutures. Cancer recurrence was initially suspected, but histopathological analysis of a biopsy specimen confirmed foreign body granuloma. Discussion: Chemoradiation therapy may enhance the immunoreaction of macrophages in the radiation field and promote the formation of granulation tissue in a short period of time. In addition, cisplatin, which was concurrently administered with radiation in our case, could have influenced the development of the suture granuloma. Conclusion: In addition to tumor recurrence, suture granulomas should be considered a differential diagnosis for nodules occurring after surgery, even if they develop in the field of radiation.