Can near-infrared imaging distinguish a gelatin-based matrix granuloma from a malignancy in a kidney?

Abstract

Aim: Differentiating granulomas from cancerous tissue poses a significant challenge in upper urinary tract surgery. We present the case of a 62-year-old male with a gelatin-based matrix (Surgiflo^TM) granuloma in the kidney following renal cyst decortication eight years earlier.

Methods: Contrast-enhanced abdominal tomography revealed a Bosniak type-4 cyst at the previous operation site. The patient underwent laparoscopic partial nephrectomy with near-infrared imaging.

Results: The lesion presented as hypofluorescent relative to normal kidney tissue. Histopathological examination revealed a foreign body granuloma due to unabsorbed Surgiflo.

Conclusion: The fluorescence pattern could not distinguish a Surgiflo granuloma from a malignant lesion of the kidney.

Keywords:

• Laparoscopy
• partial nephrectomy
• gelatin matrix granuloma
• near-infrared imaging

Disclosure statement

No potential conflict of interest was reported by the author(s).