Extravesical foreign body presenting as a bladder tumor

Post-nephrectomy foreign-body granuloma in the retroperitoneum mimicking lymph node metastasis of renal cell cancer

Recently, iatrogenic foreign-body granuloma has been increasingly reported. The asymptomatic presentation and confusing appearance of granuloma can lead to misdiagnosis of a secondary malignancy, especially for a patient with a corresponding past medical history. Sometimes, surgical treatment is unavoidable, and the diagnosis relies upon the pathologic result. Herein, we report an unusual case of a 43-year-old man who underwent a nephrectomy for renal cell carcinoma (clear cell type) 5 years ago. A secondary granuloma was identified behind the inferior vena cava in the retroperitoneum 6 months after the surgery, but the radiologists had failed to identify it throughout the 4 years of routine examination. Later on, the lesion was identified by positron emission tomography, which classified it as a highly 18F-fluorodeoxyglucose-avid lesion. Considering no visible foreign-bodies identified on images, the lesion was arguably diagnosed as a lymph node metastasis of renal cancer. Finally, it was confirmed as a foreign-body granuloma encasing surgical suture and adipose tissue by the pathological analysis.

Extravesical Textiloma (Gossypiboma) Mimicking a Bladder Tumor in a Dog

Sponges can be inadvertently left behind during surgery. A retained surgical sponge is called a textiloma, gossypiboma, or gauzoma. This complication is rare and rarely reported. These foreign bodies can lead to postoperative infection or abscess formation, while others remain asymptomatic for many years before leading to a granuloma with adhesions. This paper reports a case of extravesical textiloma in a spayed female dog with severe hematuria and a thickened bladder wall, mimicking a tumor on ultrasound. Clinical signs occurred >8 years after sterilization.

Foreign body reaction mimicking a second primary tumour of the oesophagus

OBJECTIVE

To present a significant complication of pharyngolaryngeal reconstruction, which resulted in diagnostic confusion as it mimicked a second primary tumour of the head and neck.

METHODS

Case report and review of the world literature.

CASE REPORT

A 61-year-old man developed a granulomatous foreign body reaction, mimicking a second primary tumour, at the distal end of a salivary bypass tube, following pharyngolaryngectomy and reconstruction using a tubed anterolateral thigh flap. Clinically and radiologically, this was felt to represent a second primary tumour of the oesophagus, but biopsies revealed full thickness inflammation of the mucosa and granulation tissue. Repeat oesophagoscopy two weeks after removal of the tube showed complete resolution.

CONCLUSION

No record of an oesophageal foreign body reaction to a Montgomery salivary bypass tube has previously been reported in the world literature. This report highlights the potential for such a lesion to cause diagnostic confusion with a second primary tumour.