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Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics

Background. Numerous reports have demonstrated how postoperative intracranial granulomas can often mimic neoplasm clinically, radiologically, and even macroscopically. Herein we present an unusual case of postsurgical intracranial aseptic granuloma secondary to a chronic inflammatory reaction withou...

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Detalles Bibliográficos
Autores principales: Ganau, Mario, Nicassio, Nicola, Tacconi, Leonello
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423776/
https://www.ncbi.nlm.nih.gov/pubmed/22924150
http://dx.doi.org/10.1155/2012/614321
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author Ganau, Mario
Nicassio, Nicola
Tacconi, Leonello
author_facet Ganau, Mario
Nicassio, Nicola
Tacconi, Leonello
author_sort Ganau, Mario
collection PubMed
description Background. Numerous reports have demonstrated how postoperative intracranial granulomas can often mimic neoplasm clinically, radiologically, and even macroscopically. Herein we present an unusual case of postsurgical intracranial aseptic granuloma secondary to a chronic inflammatory reaction without any identifiable retained foreign body. Case Description. A 71-year-old patient started complaining of severe headache seven months after surgical excision of WHO Grade I right frontal falx meningioma. CT and MRI scans disclosed a contrast-enhanced lesion with diffuse mass effect in the previous surgical site. The lesion was resected; intraoperative finding and histological specimens led to the diagnosis of postoperative granuloma, likely expression of a glial reaction to the fluid absorbable hemostatics applied in the surgical site after meningioma excision. The possible granuloma-inducing materials and the timing of granuloma formation are discussed. Conclusion. A comprehensive analysis of clinical and neuroradiological data, as well as results of blood tests including positive and negative acute phase proteins, is mandatory to raise the suspicion of postoperative granuloma. The treatment options should be evaluated on a case-by-case basis, with a conservative attitude being the one of choice only for patients without progressive neurological deficit. Alternatively, aggressive surgical treatment and histopathological examination should be advocated.
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spelling pubmed-34237762012-08-24 Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics Ganau, Mario Nicassio, Nicola Tacconi, Leonello Case Rep Surg Case Report Background. Numerous reports have demonstrated how postoperative intracranial granulomas can often mimic neoplasm clinically, radiologically, and even macroscopically. Herein we present an unusual case of postsurgical intracranial aseptic granuloma secondary to a chronic inflammatory reaction without any identifiable retained foreign body. Case Description. A 71-year-old patient started complaining of severe headache seven months after surgical excision of WHO Grade I right frontal falx meningioma. CT and MRI scans disclosed a contrast-enhanced lesion with diffuse mass effect in the previous surgical site. The lesion was resected; intraoperative finding and histological specimens led to the diagnosis of postoperative granuloma, likely expression of a glial reaction to the fluid absorbable hemostatics applied in the surgical site after meningioma excision. The possible granuloma-inducing materials and the timing of granuloma formation are discussed. Conclusion. A comprehensive analysis of clinical and neuroradiological data, as well as results of blood tests including positive and negative acute phase proteins, is mandatory to raise the suspicion of postoperative granuloma. The treatment options should be evaluated on a case-by-case basis, with a conservative attitude being the one of choice only for patients without progressive neurological deficit. Alternatively, aggressive surgical treatment and histopathological examination should be advocated. Hindawi Publishing Corporation 2012 2012-08-09 /pmc/articles/PMC3423776/ /pubmed/22924150 http://dx.doi.org/10.1155/2012/614321 Text en Copyright © 2012 Mario Ganau et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Ganau, Mario
Nicassio, Nicola
Tacconi, Leonello
Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics
title Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics
title_full Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics
title_fullStr Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics
title_full_unstemmed Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics
title_short Postoperative Aseptic Intracranial Granuloma: The Possible Influence of Fluid Hemostatics
title_sort postoperative aseptic intracranial granuloma: the possible influence of fluid hemostatics
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423776/
https://www.ncbi.nlm.nih.gov/pubmed/22924150
http://dx.doi.org/10.1155/2012/614321
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