J Korean Orthop Assoc.  2012 Jun;47(3):216-221. 10.4055/jkoa.2012.47.3.216.

Gossypiboma Mimicking a Soft Tissue Tumor

• Kang CN
• Kee YM
• Choi CH

• KMID: 2106651
• DOI: http://doi.org/10.4055/jkoa.2012.47.3.216

Abstract

Paraspinal or extremity foreign-body reactions are a rare disease, which could be caused by foreign bodies to prevent intraoperative bleeding and can result in severe complications or death. However, they are often neglected. We report three cases of paraspinal and parapelvic gossypiboma mimicking a soft tissue tumor on magnetic resonance imaging, which were diagnosed and treated by surgical excision.

Keyword

gossypiboma; foreign-body granulama; surgical gauze

MeSH Terms

Extremities
Foreign Bodies
Hemorrhage
Magnetic Resonance Imaging
Rare Diseases

Figure

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  Figure 1 (A) Sagittal T1-weighted magnetic resonance image (MRI) shows hypointense, ellipsoid lesion with a central hypointense nidus in the left paravertebral soft tissue at the level of L4-5. (B) Sagittal T2-weighted MRI with contrast medium demonstrates a ring-enhanced, hyperintense lesion.

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  Figure 2 The excised specimen was cut. Retained sponge material was found within the thick capsule of the paraspinal mass.

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  Figure 3 Histological findings (H&E staining). Submitted as a grayish white partially calcified fat tissue. Foreign body (gauze) granuloma (×200).

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  Figure 4 (A) Coronal T1 weighted magnetic resonance image (MRI) with contrast medium shows well-encapsulated inhomogenous mass with peripheral rim enhancement. (B) Coronal and (C) Axial T2 weighted MRI show a well-encapsulated complex mass containing hyper and hypointense regions. Central low and high signal intensity, peripheral low signal rim.

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  Figure 5 (A) Submitted subcutaneous mass, measuring 16×14×18 cm with a weight of 450 g. The cut surface of the section shows a cystic space, containing purulent exudates and (B) gauze.

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  Figure 6 Histological findings. Cystic mass with a thick fibrous hyallinized wall (H&E stain, ×12.5) with central cystic degeneration. Foreign body (gauze) granuloma.

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  Figure 7 (A) Sagittal T2 weighted magnetic resonance image (MRI) shows the well-defined paravertebral soft tissue mass. Central low and high signal intensity, with a peripheral low signal rim. (B) Sagittal T1 weighted MRI with contrast medium shows the defined paravertebral soft tissue mass with peripheral rim enhancement.

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  Figure 8 The cut surface of the cystic mass section revealed foreign material (cotton), which was surrounded by a thick fibrous wall.

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