J Korean Soc Radiol.  2011 Mar;64(3):217-220. 10.3348/jksr.2011.64.3.217.

Intracranial Gossypiboma Mimicking a Recurrent Low Grade Astrocytoma: Case Report

• Lee JY
• Koo JB

• KMID: 2097940
• DOI: http://doi.org/10.3348/jksr.2011.64.3.217

Abstract

Gossypiboma is an inflammatory pseudomass formed by a retained surgical sponge or gauze with reactive tissue after surgery. Gossypiboma has been reported most frequently after abdominal or thoracic surgery. As such, gossypiboma following brain surgery is very rare. We report a case of gossypiboma mimicking tumor recurrence in the brain after a craniotomy and surgical excision of a low grade astrocytoma.

MeSH Terms

Astrocytoma
Brain
Craniotomy
Magnetic Resonance Imaging
Recurrence
Surgical Sponges
Thoracic Surgery
Tomography, X-Ray Computed

Figure

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  Fig. 1 CT and MR imaging show low grade astrocytoma in left temporal lobe. A. CT axial scan shows 2 × 2 cm ovoid dense calcified mass in left temporal lobe. B. T1-weighted axial image shows low signal intensity mass in left temporal lobe. C. T2-weighted axial image shows low signal intensity mass in left temporal lobe with minimal peritumoral edema. D. Contrast enhanced T1-weighted axial image shows no definite enhancement in mass.

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  Fig. 2 After 6 months of the operation, the follow up CT and MR show intracranial gossypiboma mimicking recurrent low grade astrocytoma. A. CT axial scan shows 1 × 1.4 cm irregular heterogeneous slightly high density mass (arrow) in previous tumor resection site of left temporal lobe. B. T1-weighted axial image shows irregular shaped iso signal intensity mass (arrow) in left temporal lobe. C. T2-weighted axial image shows irregular shaped low signal intensity mass (arrow) in left temporal lobe. D. Contrast enhanced T1-weighted axial image shows relatively homogeneous enhancement in mass (arrow) in left temporal lobe.

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  Fig. 3 Microscopic finding shows intracranial gossypiboma. A. The low-power magnification shows a well-defined foreign body reaction within the brain parenchyme (×40). B. Higher magnification reveals multinucleated giant cells engulfing foreign body material surrounded by interstitial fibrosis and inflammation (× 200).

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