title: Surgicel application in intracranial hemorrhage surgery contributed to giant-cell granuloma in a patient with hypertension: case report and review of the literature.
abstract: BACKGROUND
  Surgicel is an oxidized cellulose preparation that is widely applied in neurosurgery due to its hemostatic effect and good tissue compatibility. Tumor-like lesions induced by Surgicel application in cerebral surgery have been rarely reported, especially for intracranial hemorrhage debridement surgery in patients with hypertension.
  
  
  METHODS
  This case report describes a rare case in which Surgicel application led to a foreign body reaction, contributing to the development of an intracranial giant-cell granuloma. A 49-year-old female hypertensive patient was diagnosed with intracranial hemorrhage. She was treated with debridement surgery that employed Surgicel application. Although a satisfactory hemostatic effect was achieved, the patient was diagnosed with epilepsy 6 months later. Subsequent magnetic resonance imaging revealed an intracranial space-occupying lesion. After undergoing en bloc resection of the lesion, the patient was diagnosed with a Surgicel-related intracranial giant-cell granuloma by histopathology.
  
  
  CONCLUSIONS
  Application of Surgicel during intracranial hemorrhage debridement surgery may be associated with a risk of granuloma development due to formation of a tumor-like space-occupying lesion in the surgery bed. Even a low risk of tumor development implies a need for caution when applying Surgicel, especially when solely used to achieve a hemostatic effect.
authors.forename: Bowen
authors.initials: B
authors.lastname: Lin
authors.forename: Hongfa
authors.initials: H
authors.lastname: Yang
authors.forename: Mengzhao
authors.initials: M
authors.lastname: Cui
authors.forename: Ye
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, First Hospital of Jilin University, 71 Xinmin Avenue, Changchun 130021, China. jinluyu@hotmail.com.
authors.forename: Jinlu
authors.initials: J
authors.lastname: Yu
mesh_terms: D002483:Cellulose, Oxidized / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006101:Granuloma, Giant Cell / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000150:complications / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis
chemical_list: D002483:Cellulose, Oxidized; C013695:Surgicel
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