Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Skeletal Radiology
Published in: Skeletal Radiology 4/2019

01-04-2019 | Case Report

Extremity gossypiboma mimicking sarcoma: case report and review

Authors: Varun Puvanesarajah, Laura M. Fayad, Sandesh S. Rao, Edward F. McCarthy, Carol D. Morris

Published in: Skeletal Radiology | Issue 4/2019

Login to get access

Abstract

A 70-year-old man with a history of bladder and colon cancer presented with an enlarging mass in his right lower extremity. Forty years before presentation, he had injured his right lower extremity in a motor vehicle accident. Imaging findings indicated suspected sarcoma, which led to biopsy. Biopsy and further surgical exploration revealed the presence of a surgical sponge and surrounding local inflammatory reaction. No neoplasm was found, and the sponge and involved tissues were removed. Gossypiboma is exceedingly rare in the extremities. Imaging of retained foreign material can appear suggestive of sarcoma because of strong inflammatory responses and local tissue mass-like derangement resulting in heterogeneous signal changes. Ultimately, biopsy must be performed to ensure that no oncological pathological condition is present.
Literature
1.
Cima RR, Kollengode A, Garnatz J, Storsveen A, Weisbrod C, Deschamps C. Incidence and characteristics of potential and actual retained foreign object events in surgical patients. J Am Coll Surg. 2008;207:80–7.CrossRefPubMed
2.
Egorova NN, Moskowitz A, Gelijns A, et al. Managing the prevention of retained surgical instruments: what is the value of counting? Ann Surg. 2008;247:13–8.CrossRefPubMed
3.
Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk factors for retained instruments and sponges after surgery. N Engl J Med. 2003;348:229–35.CrossRefPubMed
4.
5.
Kalbermatten DF, Kalbermatten NT, Hertel R. Cotton-induced pseudotumor of the femur. Skeletal Radiol. 2001;30:415–7.CrossRefPubMed
6.
7.
8.
Malot R, Meena DS. Gossypiboma of the thigh mimicking soft tissue sarcoma: case report and review of literature. J Orthop Case Rep. 2012;2:21–4.PubMedCentralPubMed
9.
Mouhsine E, Garofalo R, Cikes A, Leyvraz PF. Leg textiloma. A case report. Med Princ Pract. 2006;15:312–5.CrossRefPubMed
10.
Nakamura T, Kusuzaki K, Matsubara T, Matsumine A, Uchida A. Foreign-body granulomas in the trunk and extremities may simulate malignant soft-tissue tumors: report of three cases. Acta Radiol. 2008;49:80–3.CrossRefPubMed
11.
Sakayama K, Fujibuchi T, Sugawara Y, Kidani T, Miyawaki J, Yamamoto H. A 40-year-old gossypiboma (foreign body granuloma) mimicking a malignant femoral surface tumor. Skeletal Radiol. 2005;34:221–4.CrossRefPubMed
12.
Sexton CC, Lawson JP, Yesner R. Case report 174: "Cottonballoma" of femur (due to retained surgical sponge with foreign body giant cell reaction). Skeletal Radiol. 1981;7:211–3.CrossRefPubMed
13.
Hyslop JW, Maull KI. Natural history of the retained surgical sponge. South Med J. 1982;75:657–60.CrossRefPubMed
14.
Jason RS, Chisolm A, Lubetsky HW. Retained surgical sponge simulating a pancreatic mass. J Natl Med Assoc. 1979;71:501–3.PubMedCentralPubMed
15.
Gibbs VC, Coakley FD, Reines HD. Preventable errors in the operating room: retained foreign bodies after surgery—part I. Curr Probl Surg. 2007;44:281–337.CrossRefPubMed
16.
Bani-Hani KE, Gharaibeh KA, Yaghan RJ. Retained surgical sponges (gossypiboma). Asian J Surg. 2005;28:109–15.CrossRefPubMed
17.
Gonzalez-Ojeda A, Rodriguez-Alcantar DA, Arenas-Marquez H, et al. Retained foreign bodies following intra-abdominal surgery. Hepatogastroenterology. 1999;46:808–12.PubMed
18.
Abdul-Karim FW, Benevenia J, Pathria MN, Makley JT. Case report 736: retained surgical sponge (gossypiboma) with a foreign body reaction and remote and organizing hematoma. Skeletal Radiol. 1992;21:466–9.PubMed
19.
al Arabi K, Beg M, Snowdy H, Whittaker R. Pathological fracture due to retained surgical gauze. J Bone Joint Surg Br. 1992;74:930–1.CrossRefPubMed
20.
Bevernage C, Geusens E, Nijs S. Case report: a gossypiboma in the shoulder. Emerg Radiol. 2006;12:231–3.CrossRefPubMed
21.
Iwase T, Ozawa T, Koyama A, Satake K, Tauchi R, Ohno Y. Gossypiboma (foreign body granuloma) mimicking a soft tissue tumor with hip hemiarthroplasty. J Orthop Sci. 2007;12:497–501.CrossRefPubMed
22.
Kominami M, Fujikawa A, Tamura T, Naoi Y, Horikawa O. Retained surgical sponge in the thigh: report of the third known case in the limb. Radiat Med. 2003;21:220–2.PubMed
23.
Mboti B, Gebhart M, Larsimont D, Abdelkafi K. Textiloma of the thigh presenting as a sarcoma. Acta Orthop Belg. 2001;67:513–8.PubMed
24.
25.
Puri A, Anchan C, Jambhekar NA, Agarwal MG, Badwe RA. Recurrent gossypiboma in the thigh. Skeletal Radiol. 2007;36:S95–S100.CrossRefPubMed
26.
Sadeghifar AR, Saeed AR. Infected textiloma, 35 years after the operation for femur fracture, an extremely rare occurrence. Arch Bone Jt Surg. 2013;1:41–3.PubMedCentralPubMed
27.
Shiraev T, Bonar SF, Stalley P, Anderson SE. MRI "row of dots sign" in gossypiboma: an enlarging mass 8 months after sarcoma resection. Skeletal Radiol. 2013;42:1017–9.CrossRefPubMed
28.
Suh DH, Yoon JR, Kang KB, Han SB, Kim HJ, Lee SJ. A gossypiboma-induced pathological fracture of the proximal femur. Clin Radiol. 2009;64:1132–5.CrossRefPubMed
29.
Uchida K, Nakajima H, Yayama T, et al. Unusual foreign body granuloma (gauzoma) found 46 years after open reduction and fixation surgery for femoral shaft fracture. Joint Bone Spine. 2010;77:486–7.CrossRefPubMed
30.
Lu YY, Cheung YC, Ko SF, Ng SH. Calcified reticulate rind sign: a characteristic feature of gossypiboma on computed tomography. World J Gastroenterol. 2005;11:4927–9.CrossRefPubMedCentralPubMed
31.
Roumen RM. Weerdenburg HP. MR features of a 24-year-old gossypiboma. A case report. Acta Radiol. 1998;39:176–8.CrossRefPubMed
32.
Mercier M, Noailles T, Sali E, Carret P, Duvauferrier R, Rouvillain JL. What type of imaging work-up will help to confirm the diagnosis of gossypiboma in the limb? Review of literature. Orthop Traumatol Surg Res. 2016;102:795–800.CrossRefPubMed
33.
Bellin M, Hornoy B, Richard F, et al. Perirenal textiloma: MR and serial CT appearance. Eur Radiol. 1998;8:57–9.CrossRefPubMed
34.
O'Keefe RJ, O'Connell JX, Temple HT, et al. Calcific myonecrosis. A late sequela to compartment syndrome of the leg [see comments]. Clin Orthop Relat Res. 1995;318:205–13.
35.
Janzen DL, Connell DG, Vaisler BJ. Calcific myonecrosis of the calf manifesting as an enlarging soft-tissue mass: imaging features. AJR Am J Roentgenol. 1993;160:1072–4.CrossRefPubMed
36.
Constantine S, Brennan C, Sebben R. Calcific myonecrosis: case report and radiopathological correlation. Australas Radiol. 2007;51 Spec No.:B77–81.CrossRefPubMed
37.
O'Dwyer HM, Al-Nakshabandi NA, Al-Muzahmi K, Ryan A, O'Connell JX, Munk PL. Calcific myonecrosis: keys to recognition and management. AJR Am J Roentgenol. 2006;187:W67–76.CrossRefPubMed
38.
Ben-Izhak O, Kerner H, Brenner B, Lichtig C. Angiosarcoma of the colon developing in a capsule of a foreign body. Report of a case with associated hemorrhagic diathesis. Am J Clin Pathol. 1992;97:416–20.CrossRefPubMed
39.
Cokelaere K, Vanvuchelen J, Michielsen P, Sciot R. Epithelioid angiosarcoma of the splenic capsule. Report of a case reiterating the concept of inert foreign body tumorigenesis. Virchows Arch. 2001;438:398–403.CrossRefPubMed
40.
Jennings TA, Peterson L, Axiotis CA, Friedlaender GE, Cooke RA, Rosai J. Angiosarcoma associated with foreign body material. A report of three cases. Cancer. 1988;62:2436–44.CrossRefPubMed
41.
Joo YT, Jeong CY, Jung EJ, et al. Intra-abdominal angiosarcoma developing in a capsule of a foreign body: report of a case with associated hemorrhagic diathesis. World J Surg Oncol. 2005;3:60.CrossRefPubMedCentralPubMed
Metadata
Title
Extremity gossypiboma mimicking sarcoma: case report and review
Authors
Varun Puvanesarajah
Laura M. Fayad
Sandesh S. Rao
Edward F. McCarthy
Carol D. Morris
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 4/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-018-3059-5

Other articles of this Issue 4/2019

Skeletal Radiology 4/2019 Go to the issue

Technical Report

Modified technique for imaging the wrist and elbow in obese and claustrophobic patients using a non-open standard MRI scanner

Test Yourself: Question

Worsening right hip pain

Scientific Article

Ultrasound-guided injection for the diagnosis and treatment of posteromedial knee friction syndrome

Scientific Article

Magnetic resonance imaging of the craniovertebral junction in early rheumatoid arthritis

Case Report

Calcified leiomyoma of the deltoid: pathophysiology and imaging review

Technical Report

Initial experience with dual-energy computed tomography-guided bone biopsies of bone lesions that are occult on monoenergetic CT