[Intracranial textiloma]

Intracranial Textiloma: Imaging Features and Literature Review

Background and Importance Intracranial textilomas are retained surgical sponges presenting as pseudomass lesions in postoperative patients usually with surrounding inflammatory reaction. Though rare, these are commonly misdiagnosed as postoperative hemorrhagic collections, abscesses, radionecrosis, or residual/recurrent mass lesions. We describe the imaging findings of intracranial textilomas diagnosed in four patients on follow-up postoperative imaging along with their characteristic imaging findings to help radiologists/neurosurgeons make accurate diagnosis.

Clinical Presentation One patient had chronic headache without any focal neurological deficits. Rest of the patients were asymptomatic at the time of presentation

Conclusion In postoperative scans, possibility of textilomas should be considered apart from residual/recurrent lesions, postoperative abscesses, or radionecrosis. Correct and timely diagnosis is important for further treatment planning and patient care.

Textiloma: an uncommon complication of posterior lumbar surgery

A surgical sponge or cotton swab that is inadvertently left behind in a surgical wound eventually becomes a "textiloma". Such foreign material (also called "gossypiboma") can cause a foreign-body reaction in the surrounding tissue. Textiloma is mostly asymptomatic in chronic cases, but can be confused with other soft-tissue masses. Therefore, it is important to be aware of patients who present with a paraspinal soft-tissue mass and unusual or atypical symptoms. Imaging is helpful for arriving at the correct diagnosis. Here, we describe a case of textiloma in which the patient presented with low-back pain 6 years after laminectomy and lumbar discectomy. Spinal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mass lesion in the posterior paravertebral region.