Schloffer's tumor: Case report and review of the literature

Abstract

INTRODUCTIONThe so-called Schloffer tumor (ST) is a rare inflammatory pseudotumor. It usually appears several years after abdominal surgery or trauma.PRESENTATION OF CASEA 32-year-old man was referred to our hospital complaining of a painful mass in the left hypochondrium, postprandial distension and a weight loss of about 14 kg. He had had a left inguinal hernioplasty without mesh the previous year. Ultrasonography of the abdomen showed a 2 cm × 2 cm hypoechoic lesion in contact with the abdominal wall. Computerized tomography of the abdomen showed a heterogeneous mass in the great omentum.Laparoscopic exploration revealed an omental mass firmly attached to the abdominal wall. A great deal of purulent fluid spread during the procedure. Due to the difficult exploration, the procedure converted to hand assisted laparoscopy. We find an omental tumor involving the stomach and the transverse colon. Inside the mass there were purulent material and non-absorbable sutures. A drain was left inside the cavity of the abscess. Histological examination showed chronic inflammation.DISCUSSIONST characteristically presents a central chronic abscess containing non-absorbable sutures. It has been described after appendectomy, hernioplasty, hysterectomy, gastrectomy or colonic resections. Although benign, its progressive growth and infiltrating behavior resemble malignant tumors.CONCLUSIONWe suggest that a mini-invasive approach should always be performed. The interesting thing about this case is the appearance of the tumor in a place far away from the previous surgical site. A simple drainage and removal of suture material solves the problem of these patients.

Suture‐induced arthritis as a clinical mimicker of septic arthritis

“…There is a similar pathological condition in which artificial devices can cause adverse tissue reactions, namely Schloffer tumor. This is a rare inflammatory pseudotumor induced by nonabsorbable surgical sutures months to years postoperatively . Reactive fibrous granulomas with low virulent staphylococcal or streptococcal infections are the essential condition .…”

“…This is a rare inflammatory pseudotumor induced by nonabsorbable surgical sutures months to years postoperatively . Reactive fibrous granulomas with low virulent staphylococcal or streptococcal infections are the essential condition . Removing the foreign body and debridement are essential for treatment.…”

Lesiones ocupantes de espacio en pared abdominal (no herniaria). La visión del patólogo

“…Se trata de una lesión inflamatoria granulomatosa que se da tras una intervención quirúrgica donde se ha empleado sutura no absorbible u otro material tipo cuerpo extraño [1][2][3][4][5]8 . En la mayoría de las cicatrices de laparotomías previas encontramos este tipo de lesión, donde se observan abundantes células gigantes tipo cuerpo extraño, restos de material de sutura con histiocitos, fibrosis, hemorragia y necrosis.…”

“…Raramente puede observarse la transformación maligna de una endometriosis, que es muy difícil de diferenciar de una metástasis por adenocarcinoma en pared abdominal, al menos desde el punto de vista patológico. El diagnóstico diferencial se debe realizar con las fibromatosis, reacción granulomatosa con hemorragia, necrosis grasa, fascitis nodular (FN) y metástasis por adenocarcinoma de origen ginecológico o intestinal [1][2][3][4][5][6][7][8] .…”

Intra-abdominal suture granulomas masquerading as colon carcinoma: a case report

“…It is utmost important to timely diagnose this entity as it can mimic other abdominal conditions like a perforation, an abscess or a tumor, leading to inessential aggressive therapeutic interventions and further complications. [15][16][17][18][19] We describe one such unusual case of intra-abdominal suture granulomas in a 45-year-old male which simulated as a colon cancer.…”