title: Bolster material granuloma masquerading as recurrent renal cell carcinoma following partial nephrectomy.
abstract: Nephron sparing surgery has seen a phenomenal rise in its application over the past few decades. The use of Surgicel and gel foam for closure of defect created after partial nephrectomy has become a routine practice at many centers. In this case report, we describe radiological artifact secondary to a surgical bolster mimicking a residual disease or an early recurrence in the kidney. This case highlights two facts; first, reapproximation of the renal tissue is best done without the use of Surgicel bolsters. Second, bolsteroma should always be kept in mind as a differential diagnosis in a case where computed tomography (CT) imaging is showing early recurrence. If the surgeon is sure about the surgical margins being negative and the CT image shows a bolsteroma, the patient should be observed and a repeat scan should be done at 3-6 months, which would show regression or disappearance of the lesion proving it to be an artifact rather than malignant lesion.
authors.affiliation: Department of Urology and Radiology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Urology and Radiology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Shrikant
authors.initials: S
authors.lastname: Jai
authors.affiliation: Department of Urology and Radiology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Sanika
authors.initials: S
authors.lastname: Ganpule
authors.affiliation: Department of Urology and Radiology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Ganpule
keywords: Bolsteroma; Surgicel; partial nephrectomy