Published online Jul 16, 2014.
https://doi.org/10.12671/jkfs.2014.27.3.227
Granulation Tissue Formed by Stimulating K-Wire Mimicking Tuberculous Cervical Lymphadenopathy: A Case Report
Abstract
Pins and wires are still used frequently in surgeries of the shoulder; however, these can cause breakage or migration to surrounding tissues, leading to complications. We report on case of a patient with a neck mass who had a past history of pulmonary tuberculosis and distal clavicle fracture with internally fixated state. She was misdiagnosed as tuberculous cervical lymphadenopathy and treated for approximately one year, but was finally revealed as granulation tissue around the internally fixated distal clavicle fracture site, thus, mass excision and metal removal was performed. This case shows the importance of a proper selection device, internal fixation technique, duration, and close follow-up after the operation.
Fig. 1
Preoperative plane radiograph showed mild medial migration of K-wire.
Fig. 2
Axial cervical computed tomography scans. About 2.5 cm sized rim enhancing low density mass was seen at supraclavicular area. The tip of K-wire was in the mass. Black arrow: rim enchanced mass. White arrow: K-wire. (A) Lung setting, (B) bone setting.
Fig. 3
Coronal cervical computed tomography scans confirmed migration of the K-wire into the mass, showing irritation of the mass by tip of the K-wire.
Fig. 4
(A) Intraoperative finding of soft tissue mass during excional biopsy. (B) After excisional biopsy about 5.0×3.0×1.5 cm sized mass was removed.
Fig. 5
At the pathologic study nonspecific granulation tissue was seen (A, B), and local fibrosis was seen (black arrow) (H&E; A: ×40, B: ×100).
Financial support: None.
Conflict of interest: None.
References
-
Cheon SJ, Lee JM. Early intrathoracic migration of K-wire used for fixation of proximal humerus fracture. J Korean Orthop Assoc 2011;46:167–171.
-
-
Lee BI, Kim YB, Choi HS, Kim CH, Ji JW. Spinal canal migration of a K-wire used for fixation of a distal clavicular fracture. J Korean Orthop Assoc 2013;48:231–235.
-
-
Jean JL, Lee CH, Chu CM, Hsieh SP, Tang HL. Pseudocyst formation after intertrochanteric fracture fixation: a case report. J Formos Med Assoc 2001;100:285–288.
-
-
Bisbinas I, Mikalef P, Gigis I, Beslikas T, Panou N, Christoforidis I. Management of distal clavicle fractures. Acta Orthop Belg 2010;76:145–149.
-
-
Wu K, Chang CH, Yang RS. Comparing hook plates and Kirschner tension band wiring for unstable lateral clavicle fractures. Orthopedics 2011;34:e718–e723.
-
-
Wang SG. Differential diagnosis and treatment of neck masses. J Korean Med Assoc 2007;50:613–625.
-