title: Nonabsorbable suture granuloma mimicking ovarian cancer recurrence at combined positron emission tomography/computed tomography evaluation: a case report.
abstract: BACKGROUND
  This is the first case of suture granuloma mimicking isolated ovarian cancer relapse. Only six analogous cases have been previously reported in other malignancies.
  
  
  METHODS
  We report the case of a 44-year-old Caucasian woman with partially platinum-sensitive ovarian cancer in which radiological features, including computed tomography and combined 18F-fluorodeoxyglucose-positron emission tomography/computed tomography, were strongly suggestive of isolated cancer relapse in her right subdiaphragmatic region. Laparoscopic examination resulted negative, but was not completely suitable due to widespread adhesive syndrome. The laparotomy for secondary cytoreductive surgery and biopsy of the suspected area showed inflammatory granuloma caused by nonabsorbable propylene suture, without evidence of neoplastic cells. Moreover, unexpected peritoneal carcinosis was found.
  
  
  CONCLUSIONS
  This evidence suggests that clinical details about previous surgical procedures are necessary for adequate interpretation. Although much progress has been made in imaging techniques, especially in the promising field of combined 18F-fluorodeoxyglucose positron emission tomography/computed tomography, these procedures should be still thoroughly investigated in order to promptly rule out tumor recurrence and avoid unnecessary surgery.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Imperiale
authors.affiliation: Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Via del Policlinico, 155, 00161 Rome, Italy. clamarchetti@libero.it.
authors.forename: Claudia
authors.initials: C
authors.lastname: Marchetti
authors.forename: Laura
authors.initials: L
authors.lastname: Salerno
authors.forename: Roberta
authors.initials: R
authors.lastname: Iadarola
authors.forename: Carlotta
authors.initials: C
authors.lastname: Bracchi
authors.forename: Laura
authors.initials: L
authors.lastname: Vertechy
authors.forename: Lucia
authors.initials: L
authors.lastname: di Francesco
authors.forename: Angela
authors.initials: A
authors.lastname: Musella
authors.forename: Elisa
authors.initials: E
authors.lastname: Bevilacqua
authors.forename: Primo
authors.initials: P
authors.lastname: Pennesi
authors.forename: Innocenza
authors.initials: I
authors.lastname: Palaia
authors.forename: Pierluigi Benedetti
authors.initials: PB
authors.lastname: Panici
mesh_terms: D000328:Adult; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D015745:Granuloma, Foreign-Body / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010053:Ovary / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D012008:Recurrence; D013537:Sutures / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed