This paper deals with our experience in the management of four patients who have come to our notice during the past 15 years, each presenting with a clinical picture strongly suggestive of bladder malignancy. Each of them had, however, some months or years prior to the development of urinary symptoms, undergone an inguinal herniorrhaphy in which silk had been used for the repair. The pseudo‐neoplasm of the bladder was believed in each instance to be due to a paravesical granuloma following the use of non‐absorbable sutures. Awareness of this complication helped to prevent unnecessary major surgery in two of the four patients.
SUMMARYA 60-year-old woman underwent a metal on polyethylene total hip replacement. The patient experienced pain and sustained multiple dislocations over the following 2 years and was referred for consideration of revision surgery. At the time of revision surgery it was found that there was a significant amount of polyethylene wear likely to have arisen as a result of the neutral cup placement and subsequent anterior impingement. A large cystic mass was excised and on histology was found to contain tissue with a lymphocytic infiltrate with a large amount of intracellular birefringent debris, consistent with polyethylene. The appearance of such masses is well reported as pseudotumours in metal-on-metal hip replacements but as yet their aetiology is unknown. We believe that the formation of the mass in this case could represent a model by which these pseudotumours occur.
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