title: A granulomatous reaction to Avitene mimicking recurrence of a medulloblastoma. Case report.
abstract: Microfibrillar collagen hemostat (MCH), also known by its trade name Avitene, is commonly used to control hemorrhage during neurosurgery. Among the documented complications associated with this agent, a granulomatous foreign body reaction is rare, having been described in the central nervous system in only one previous clinical report. In the present study, the authors report the case of a 3-year-old boy who presented with a lesion which appeared to be the recurrence of a tumor 2 months after he had undergone gross-total resection for a medulloblastoma. The patient underwent resection of the presumed recurrent tumor, but histopathological analysis of the specimen revealed a granulomatous foreign body reaction to MCH and no tumor recurrence. In addition to describing the case, the authors review the surgical literature on foreign body reactions to MCH.
authors.affiliation: Division of Pediatric Neurosurgery, Department of Pathology, and Division of Pediatric Hematology/Oncology, Children's Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60614, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: O'Shaughnessy
authors.forename: Kristian T
authors.initials: KT
authors.lastname: Schafernak
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: DiPatri
authors.forename: Stewart
authors.initials: S
authors.lastname: Goldman
authors.forename: Tadanori
authors.initials: T
authors.lastname: Tomita
mesh_terms: D002528:Cerebellar Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002675:Child, Preschool; D003094:Collagen / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015745:Granuloma, Foreign-Body / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D019635:Neurosurgical Procedures / Q000009:adverse effects*
chemical_list: D003094:Collagen