Postoperative starch granuloma revealed as femoral herniation. A case report.

A rare case of postoperative starch granuloma in a 55-year-old woman, revealed as femoral herniation, is reported. A small, finger-tip-sized tumor showing femoral herniation was noticed 3 weeks after cholecystectomy for cholelithiasis, and no content in the hernia sac was noticed. Histologically, the granuloma situated in the wall of the hernia sac was diagnosed as a starch granuloma consisting of starch granules, which were clearly revealed by polarized light microscopy. These granules were detected in the cytoplasm of macrophages including multinucleated types, some showing a positive immune reaction with antibodies to the alpha-subunit of S-100 protein, vimentin and lysozyme. Starch granules from surgical gloves showed identical features by polarized light microscopy, thus proving the histogenesis of this granuloma. This is the first reported case in the Japanese literature of starch granuloma manifested as femoral herniation.