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


METHODS
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.


CONCLUSIONS
Adhesion barriers and other surgical implants may not always be completely metabolized and should be used with caution in patients with cancer.
From the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the Department of Diagnostic Radiology, Brooke Army Medical Center, Fort Sam Houston, Texas; and the Department of Obstetrics and Gynecology, Womack Army Medical Center, Fort Bragg, North Carolina.
Abigail T
AT
Shaltz
Charles A
CA
Leath
James F
JF
Wiedenhoefer
Michael J
MJ
Sundborg
D015746:Abdominal Pain / Q000175:diagnosis; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D005549:Foreign-Body Reaction / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D019344:Lactic Acid / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D017699:Pelvic Pain / Q000175:diagnosis; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage; D019736:Prostheses and Implants / Q000009:adverse effects*; D018203:Sarcoma, Endometrial Stromal / Q000175:diagnosis* / Q000209:etiology*; D000267:Tissue Adhesions / Q000175:diagnosis / Q000473:pathology / Q000601:surgery
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)
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