Foreign Body Granuloma Caused by Surgical Suture Material Mimicking Lymph Node Recurrence Detected by Delayed Phase FDG-PET/CT Imaging

Abstract

An 80-year-old man underwent right hemicolectomy for ascending colon cancer. The histopathological diagnosis was pSSpN1M0, pStage IIIa. After six months, abdominal enhanced CT showed a mass measuring 13 mm at the pancreatic head, and FDG-PET/CT detected intense FDG uptake in the region (early phase: SUVmax=5.8, late phase: SUVmax=6.9). Recurrence of colon cancer was suspected, therefore subsequent pancreatoduodenectomy was performed. The resected specimen revealed foreign body granuloma (FBG) due to a surgical suture. A case of FBG with false positive FDG-PET/CT delayed imaging findings is rare. Surgeons should be aware that FBG could be a possible differential diagnosis of disease recurrence after surgical resection.