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A 40-year-old gossypiboma (foreign body granuloma) mimicking a malignant femoral surface tumor

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Abstract

The patient was a 61-year-old man who developed gossypiboma of the left thigh and femur resulting in the imaging appearances of a malignant surface tumor. He had a past history of surgery on the left femur for open fracture 40 years previously. Radiographs and CT showed a soft tissue mass with osteolysis and periosteal thickening of the left femur. On MRI, the mass showed heterogeneous signal intensity with contrast enhancement at the periphery, suggesting a malignancy. 99mTc-HMDP bone scintigraphy showed a faint ring-like uptake, but thallium -201 scintigraphy did not show any uptake in the tumor. An extensive intralesional excision was performed. Postoperative histopathological examination showed a fibrous foreign body with reactive changes. There were neither viable cells nor atypical giant cells around the foreign body. No malignant change was evident. Based on surgical and histopathological examinations, the tumor was finally diagnosed as gossypiboma related to a retained surgical sponge.

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References

  1. Abdul-Karim FW, Benevenia J, Pathria MN, et al. Case report 736. Retained surgical sponge (gossypiboma) with a foreign body reaction and remote and organizing hematoma. Skeletal Radiol 1992; 21:466–469.

    Google Scholar 

  2. Apter S, Hertz M, Rubinstein ZJ, et al. Gossypiboma in the early post-operative period: a diagnostic problem. Clin Radiol 1990; 42:128–129.

    CAS  PubMed  Google Scholar 

  3. Bellin MF, Hornoy B, Richard F, et al. Perirenal textiloma: MR and serial CT appearance. Eur Radiol 1998; 8:57–59.

    Article  CAS  PubMed  Google Scholar 

  4. Ben-Izhak O, Kerner H, Brenner B, et al. Angiosarcoma of the colon developing in the capsule of a foreign body. Report of a case with associated hemorrhagic diagnosis. Am J Clin Pathol. 1992; 97:416–420.

    Google Scholar 

  5. Cokelaere K, Vanvuchelen J, Michielsen P, et al. Epithelioid angiosarcoma of the splenic capsule. Report of a case reiterating the concept of inert foreign body tumorigenesis. Virchows Arch 2001; 438:398–403.

    Article  CAS  PubMed  Google Scholar 

  6. Deger RB, LiVolsi VA, Noumoff JS. Foreign body reaction (gossypiboma) masking as recurrent ovarian cancer. Gynecol Oncol 1995; 56:94–96.

    Article  CAS  PubMed  Google Scholar 

  7. Jennings TA, Peterson L, Axiotis CA, et al. Angiosarcoma associated with foreign body material. A report of three cases. Cancer 1998; 62:2436–2444.

    Google Scholar 

  8. Kalbermatten DF, Kallbermatten NT, Hertel R. Cotton-induced pseudotumor of the femur. Skeletal Radiol 2001;30:415–417.

    Google Scholar 

  9. Kominami M, Fujikawa A, Tamura T, et al. Retained surgical sponge in the thigh: report of the third known case in the limb. Radiat Med 2003; 21:220–222.

    PubMed  Google Scholar 

  10. Kuwashima S, Yamato M, Fujioka M, et al. MR findings of surgically retained sponges and towels: report of two cases. Radiat Med 1993; 11:98–101.

    CAS  PubMed  Google Scholar 

  11. Lo CP, Hsu CC, Chang TH. Gossypiboma of the leg: MR imaging characteristics. A case report. Korean J Radiol 2003; 4:191–193.

    Google Scholar 

  12. Matsuki M, Matsuo M, Okada N. Case report: MR findings of a retained surgical sponge. Radiat Med 1998; 16:65–67.

    CAS  PubMed  Google Scholar 

  13. Mochizuki T, Takehara Y, Ichijo K, et al. Case report: MRI appearance of retained surgical sponge. Clin Radiol 1992; 46:66–67.

    CAS  PubMed  Google Scholar 

  14. Roumen RM, Weerdenburg HP. MR features of a 24-years-old gossypiboma. A case report. Acta Radiol 1998; 39:176–178.

    Google Scholar 

  15. Salzano A, De Rosa A, Borruso G, et al. A case of gossypiboma of the knee. Its computed tomographic diagnosis. Radiol Med (Torino) 2000; 99:188–189.

    Google Scholar 

  16. Sexton CC, Lawson JP, Yesner R. Case report 174. “Cottonballoma”. Skeletal Radiol 1981; 7:211–213.

    CAS  PubMed  Google Scholar 

  17. Shyamkumar NK, Sadhu RD, Nayak S, et al. Soft-tissue case 51. Gossypiboma. Can J Surg 2003; 46:207, 228.

    CAS  PubMed  Google Scholar 

  18. Sugimura H, Tamura S, Kakitsubata Y, et al. Magnetic resonance imaging of retained surgical sponge. Clin Imaging 1992; 16:259–262.

    Article  CAS  PubMed  Google Scholar 

  19. Sumiya H, Taki J, Higuchi T, et al. Nuclear imaging of bone tumors: thallium-201 scintigraphy. Semin Musculoskeletal Radiol 2001; 5:177–182.

    Article  CAS  Google Scholar 

  20. Van der Wall H, Murray IP, Huckstep RL, et al. The role of thallium scintigraphy in excluding malignancy in bone. Clin Nucl Med 1993; 18:551–557.

    PubMed  Google Scholar 

  21. Van Goethem JM, Parizel PM, Perdieus D, et al. MR and CT imaging of paraspinal textiloma (gossypiboma). J Comput Assist Tomogr 1991; 15:1000–1003.

    PubMed  Google Scholar 

  22. Yamato M, Ido K, Izutsu M, et al. CT and ultrasound findings of surgically retained sponges and towels. J Comput Assist Tomogr 1987; 11:1003–1006.

    CAS  PubMed  Google Scholar 

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Correspondence to Kenshi Sakayama.

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The patient was treated by Dr. Kenshi Sakayama at Ehime University Hospital, Ehime, Japan

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Sakayama, K., Fujibuchi, T., Sugawara, Y. et al. A 40-year-old gossypiboma (foreign body granuloma) mimicking a malignant femoral surface tumor. Skeletal Radiol 34, 221–224 (2005). https://doi.org/10.1007/s00256-004-0821-7

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  • DOI: https://doi.org/10.1007/s00256-004-0821-7

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