J Korean Soc Spine Surg.  2009 Mar;16(1):54-58. 10.4184/jkss.2009.16.1.54.

Gossypiboma Encountered 40 Years after Lumbar Partial Laminectomy: A Case Report

• Kim DJ
• Kong GM
• Yang DH
• Kim SH
• Moon SH

• KMID: 1473391
• DOI: http://doi.org/10.4184/jkss.2009.16.1.54

Abstract

Gossypiboma is a mass within body consisting of a cotton matrix surrounded by a foreign-body reaction. Some patients may remain asymptomatic, while others develop early persistent infected conditions. Gossypiboma should be included in a differential diagnosis of a paravertebral mass in postoperative patients, and a thorough and a careful inspection of the surgical field before closure must be performed by surgeons to avoid the complications of gossypiboma even when there are correct counts. We present a patient in whom a gossypiboma at the 4th lumbar spine was encountered 40 years after a partial laminectomy with no subjective symptoms.

Keyword

Spine; Gossypiboma

MeSH Terms

Diagnosis, Differential
Foreign-Body Reaction
Humans
Laminectomy
Spine

Figure

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  Fig. 1. A 60-year-old man who underwent left L3 and L4 partial laminectomy 40 years ago. Preoperative (A) anteroposterior and (B) lateral radiographs show left laminectomy state of L3 and L4.

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  Fig. 2. (A) Sagittal and (B) axial T1 weighted images show paravertebral mass with an intermediate signal intensity (arrows). (C) Sagittal and (D) axial T2 weighted images show a high signal intensity within the center of the lesion and a low signal intensity within the peripheral rim (arrows). (E) Sagittal and (F) axial enhanced images reveal strong enhancement of the peripheral rim of the lesion (arrows).

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  Fig. 3. Postoperative (A) anteroposterior and (B) lateral radiographs show posterior lumbar intervertebral fusion and posterolateral fusion state of L3 and L4.

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  Fig. 4. (A) Foreign materials area scattered in the sclerotic stroma with mild infiltration of lymphocytes. (B) Multiple microcalcifications are present (Hematoxylin & eosin stain, × 200).

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