title: Granuloma induced by sustained-release fluorouracil implants misdiagnosed as a hepatic tumor: A case report.
abstract: Sustained-release fluorouracil (FU) implants have been extensively used in peritoneal interstitial chemotherapy, and during surgery for gastrointestinal tumors, breast cancer and hepatic tumors. Currently, studies regarding the complications associated with sustained-release FU implants are rare. The present study describes the case of a 61-year-old male who presented with a space-occupying lesion of the left lobe of the liver six months after undergoing a radical total gastrectomy. Thus, laparoscopic exploration was performed to remove the tumor. Postoperative histological examination demonstrated that the lesion in the left lobe comprised of necrotic tissue with granulation tissue hyperplasia. Based on the surgical and postoperative histological findings, the mass was proposed to be due to a high concentration of local sustained-release FU implants. Furthermore, the drug was partially surrounded and had been insufficiently metabolized over a long time period, which was proposed to have caused necrosis, proliferation and fibrillation, and induced granuloma. In conclusion, local high concentrations of sustained-release FU implants may be associated with granuloma and this finding may enable improved management of sustained-release FU implants during surgery.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.
authors.forename: Dou-Sheng
authors.initials: DS
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.
authors.forename: Sheng-Jie
authors.initials: SJ
authors.lastname: Jin
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.
authors.forename: Rong
authors.initials: R
authors.lastname: He
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Jiang
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, Affiliated Hospital to Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yao
keywords: fluorouracil; hepatic tumor; peritoneal interstitial chemotherapy; sustained-release implants