Retained Surgicel mimicking renal tumor recurrence: A diagnostic pitfall following partial nephrectomy - A case report.

INTRODUCTION AND

IMPORTANCE

Partial nephrectomy is the standard treatment for localized renal cell carcinoma, often using oxidized cellulose (Surgicel®) for hemostasis. Retained Surgicel® may mimic tumor recurrence on imaging, posing a critical diagnostic challenge with potential for unnecessary interventions.

CASE PRESENTATION: We report a 54-year-old female with chromophobe renal cell carcinoma who underwent open partial nephrectomy with Surgicel® placement. Two years later, imaging revealed a suspicious renal mass suggesting tumor recurrence. Surgical excision and histopathology identified a foreign body granulomatous reaction to retained Surgicel®, with no malignancy detected.

CLINICAL DISCUSSION: Surgicel® typically resorbs within weeks but can occasionally cause granulomatous reactions appearing as enhancing masses with diffusion restriction on MRI, mimicking malignancy. Awareness of this entity and correlation with surgical history are essential. T2-weighted MRI assists differentiation, and biopsy confirms diagnosis, preventing unnecessary surgery.

CONCLUSION

Retained Surgicel® is a rare but important cause of false-positive tumor recurrence after partial nephrectomy. Accurate diagnosis through imaging, clinical correlation, and multidisciplinary communication can avoid misdiagnosis and unwarranted invasive procedures.