CT appearances following laparoscopic partial nephrectomy for renal cell carcinoma using a rolled cellulose bolster.
Summary of "CT appearances following laparoscopic partial nephrectomy for renal cell carcinoma using a rolled cellulose bolster."
Abstract Purpose: To describe the evolving computed tomography (CT) appearances of a cellulose surgical bolster used as a hemostatic agent in patients who undergo laparoscopic partial nephrectomy for renal cell carcinoma. Materials and methods: We retrospectively reviewed the follow-up CT studies of 33 patients with stage T1N0M0 renal carcinoma who underwent laparoscopic partial nephrectomy using a rolled, oxidized, regenerated cellulose sheet sutured in place as a bolster in the parenchymal defect. Thirteen patients undergoing laparoscopic partial nephrectomy without the use of a bolster were also evaluated to differentiate imaging features. Results: The bolster-related masses were significantly larger than those seen in the non-bolster patients. There was a decrease in size of the post-operative bolster-related mass with time. The bolster shape evolved with time, initially appearing oval, and becoming irregular with decreasing size. Equivocal increase in attenuation of 10-20 HU was seen in 6 patients. Increase in attenuation of greater than 20 HU was seen in 3 patients. There was no evidence of tumor recurrence in any of the patients. Invagination of fat was seen in two bolster-related masses at 18 months or greater. Conclusions: Cellulose bolster has a variable appearance on follow-up CT exams. Evolutionary features include reduction in bolster size and shape with time leading finally to non-visualization. Bolster enhancement can mimic abscesses and tumor recurrence.
Departments of Radiology.
This article was published in the following journal.
Name: Cancer imaging : the official publication of the International Cancer Imaging Society
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20675248
- DOI: http://dx.doi.org/10.1102/1470-7330.2010.0023
Medical and Biotech [MESH] Definitions
Carcinoma, Renal Cell
A heterogeneous group of sporadic or hereditary carcinoma derived from cells of the KIDNEYS. There are several subtypes including the clear cells, the papillary, the chromophobe, the collecting duct, the spindle cells (sarcomatoid), or mixed cell-type carcinoma.
Von Hippel-lindau Disease
An autosomal dominant disorder caused by mutations in a tumor suppressor gene. This syndrome is characterized by abnormal growth of small blood vessels leading to a host of neoplasms. They include HEMANGIOBLASTOMA in the RETINA; CEREBELLUM; and SPINAL CORD; PHEOCHROMOCYTOMA; pancreatic tumors; and renal cell carcinoma (see CARCINOMA, RENAL CELL). Common clinical signs include HYPERTENSION and neurological dysfunctions.
Carcinoma, Non-small-cell Lung
A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy.
A rare tumor of the female genital tract, most often the ovary, formerly considered to be derived from mesonephric rests. Two varieties are recognized: (1) clear cell carcinoma, so called because of its histologic resemblance to renal cell carcinoma, and now considered to be of muellerian duct derivation and (2) an embryonal tumor (called also ENDODERMAL SINUS TUMOR and yolk sac tumor), occurring chiefly in children. The latter variety may also arise in the testis. (Dorland, 27th ed)
Carcinoma, Merkel Cell
A carcinoma arising from MERKEL CELLS located in the basal layer of the epidermis and occurring most commonly as a primary neuroendocrine carcinoma of the skin. Merkel cells are tactile cells of neuroectodermal origin and histologically show neurosecretory granules. The skin of the head and neck are a common site of Merkel cell carcinoma, occurring generally in elderly patients. (Holland et al., Cancer Medicine, 3d ed, p1245)
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