Abigail T Shaltz1, Charles A Leath, James F Wiedenhoefer, Michael J Sundborg. 1. From the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the Department of Diagnostic Radiology, Brooke Army Medical Center, Fort Sam Houston, Texas; and the Department of Obstetrics and Gynecology, Womack Army Medical Center, Fort Bragg, North Carolina.
Abstract
BACKGROUND: Multiple products to prevent adhesions or lessen the risk of soft tissue attachments are commercially available. The long-term nature of these products is unknown, and they may cause foreign body reactions masquerading as recurrent disease in patients with cancer. CASE: A perimenopausal female underwent a hysterectomy and placement of a surgical implant, polylactic acid. Final pathology revealed stage IA low-grade endometrial stromal sarcoma. Areas suspicious for recurrence were noted on radiographic imaging 1 year later, resulting in exploratory surgery. The suspicious areas were found to be foreign body reactions. Mass spectrometry identified the main component of the reactions as polylactic acid. CONCLUSION: Adhesion barriers and other surgical implants may not always be completely metabolized and should be used with caution in patients with cancer.
BACKGROUND: Multiple products to prevent adhesions or lessen the risk of soft tissue attachments are commercially available. The long-term nature of these products is unknown, and they may cause foreign body reactions masquerading as recurrent disease in patients with cancer. CASE: A perimenopausal female underwent a hysterectomy and placement of a surgical implant, polylactic acid. Final pathology revealed stage IA low-grade endometrial stromal sarcoma. Areas suspicious for recurrence were noted on radiographic imaging 1 year later, resulting in exploratory surgery. The suspicious areas were found to be foreign body reactions. Mass spectrometry identified the main component of the reactions as polylactic acid. CONCLUSION: Adhesion barriers and other surgical implants may not always be completely metabolized and should be used with caution in patients with cancer.