J Korean Fract Soc.  2014 Jul;27(3):227-231. 10.12671/jkfs.2014.27.3.227.

Granulation Tissue Formed by Stimulating K-Wire Mimicking Tuberculous Cervical Lymphadenopathy: A Case Report

Affiliations
  • 1Department of Orthopedic Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea. jyujin2001@kosin.ac.kr

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.

Keyword

Clavicle; Bone wires; Granulation tissue

MeSH Terms

Bone Wires
Clavicle
Follow-Up Studies
Granulation Tissue*
Humans
Internal Fixators
Lymphatic Diseases*
Neck
Shoulder
Tuberculosis, Pulmonary

Figure

  • 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).


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