What type of imaging work-up will help to confirm the diagnosis of gossypiboma in the limb? Review of literature

Imaging Features of Soft Tissue Tumor Mimickers: A Pictorial Essay

Soft tissue lesions are commonly encountered and imaging is an important diagnostic step in the diagnosis and management of these lesions. While some of these lesions are true neoplasms, others are not. These soft tissue tumor mimickers can be due to a variety of conditions including traumatic, iatrogenic, inflammatory/reactive, infection, vascular, and variant anatomy. It is important for the radiologist and clinician to be aware of these common soft tissue tumor mimickers and their characteristic imaging features to avoid unnecessary workup and provide the best treatment outcome.

Sonographic appearance of a soft-tissue gossypiboma in the forearm with pathologic correlation

We describe the sonographic, radiologic, and histopathologic appearances of a soft tissue gossypiboma in the forearm of an 81-year-old woman with a history of a radial fracture treated with an internal fixation surgery.

[Diagnosing textiloma post-surgery]

During care follow-up, specifically local post-operative care, nurses closely monitor the surgical site both for healing and for local, regional or general risk of infection. In this context, they are on the front line of identifying and reporting any suspicious clinical conditions. We use the example of a patient who presented with textiloma following orthopaedic shoulder surgery.

Extremity gossypiboma mimicking sarcoma: case report and review

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.

Foreign Body Granuloma After Cranial Surgery: A Systematic Review of Reported Cases

BACKGROUND

In cranial surgery, different foreign body (FB) materials are used and may be left intentionally or unintentionally in the surgical field after closure, inducing a foreign body granuloma (FBG). This is a rare complication in neurosurgery, but it may be a diagnostic dilemma, with sometimes medicolegal implications.

METHODS

We performed a systematic review of the English literature between 1965 and 2018 and found a total of 77 articles concerning 100 cases of FBG caused by retained material located within the cranium or surrounding soft tissues.

RESULTS

There were 60 females and 40 males, with ages ranging from 1 to 77 years. Most initial diagnoses were cranial/intracranial tumors, trigeminal neuralgia, hemifacial spasm, intracranial aneurysm, hydrocephalus, head injury, infectious disease, and nontraumatic intracerebral hematoma. The interval from the causative surgical operation to presentation of the FBG ranged from 2 weeks to 20 years. Various radiologic modalities were used and histologic study confirmed the presence of FBG in all patients. Intentional FB was used and left in 77 patients, and unintentional FB was found postoperatively in 23 patients. Associated infection was found in 13 patients. Complete recovery was seen in 47.6% of patients with sufficient data.

CONCLUSIONS

Despite being unusual, a retained FBG should be considered in the differential diagnosis of any patient after cranial surgery. A history of surgery, clinical symptoms, physical examination findings, laboratory results, and the use of appropriate neuroimaging explorations may provide a correct preoperative diagnosis. In addition, unintentionally retained FBs are preventable errors in the operating room.

Ocular Gossypiboma: Ultrasound B-Scan Assessment of Retained Surgical Sponge After Ahmed Valve Surgery: A Case Report

PURPOSE OF THE STUDY

To present the first documented case of an ocular gossypiboma (retained foreign body) of a mitomycin-C-soaked sponge confirmed echographically using diagnostic ultrasound B-scan after Ahmed valve surgery.

PATIENTS AND METHODS

A patient who underwent phacoemulsification with Ahmed valve implantation surgery had a retained Weck-Cels sponge soaked with mitomycin-C. With the use of ocular ultrasound B-scan, the retained sponge was localized and a second procedure was performed to explant it.

CONCLUSION

In cases of ocular gossypiboma the use of ultrasound modalities can be a valuable tool especially because B-scan access is common and can be cost-effective.