Weekly Case

Title : Case 701

Age / Sex : 53 / F

Chief complaint : incidental fingind on abdomen CT

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : 송유선 (You Seon Song), 부산대병원 (Pusan National University Hospital)


Gossypiboma (textiloma)


  • Gossypiboma

    • A mass within the body that comprises a cotton matrix surrounded by a foreign-body reaction

    • Real incidence is unknown, but extremely rare after surgery

    • most frequently discovered in abdomen

  • Clinical manifestation

    • Variable

    • Spinal lesion

    • Nonspecific back or neck pain

    • None of the patients presented with signs of infection or required surgery urgently

    • Delays in diagnosis could increase mortality and morbidity

  • Radiographs : m/c used

    • Sponge contains a radiopaque marker

    • Whorl-like pattern

  • CT

    • In the abdomen, well-circumscribed masses with hyperdense material and show capsular enhancement

    • In the lumbar region, a mass posterior to the lamina with osteolytic change

    • osteolytic changes with marginal sclerosis may be evidence of the benign nature of the lesion and may be specific for gossypiboma around the lamina

  • MR

    • A well-defined round or ovoid mass with a fibrous capsule

    • T1-WI : a low or intermediate SI

    • T2-WI : a high signal intensity within the center of the lesion and a low signal intensity within the peripheral rim

    • CE : strong enhancement of the peripheral rim of the lesion


  • H.S. Kim, MR Imaging Findings of Paravertebral Gossypiboma, American Journal of Neuroradiology April 2007, 28 (4) 709-713

  • Takashi Kobayashi, et al., Gossypiboma 19 years after laminectomy mimicking a malignant spinal tumour: a case report, Journal of Medical Case Reports: 8, 311(2014) 

Correct Answer
Total applicants 31 Correct answers 14
Name Institution
김기욱 전문의
이현규 전문의
이진영 전문의
조영민 전문의
이승보 서울아산병원, 전문의
송윤아 전문의
이승훈 한양대학교병원, 전문의
김동언 서울아산병원, 전문의
박선영 한림대학교 성심병원, 전문의
김성진 365병원, 전문의
김동현 단국대학교병원, 전공의
권기언 서울아산병원, 전문의
정치형 단국대학교병원, 전공의
김형민 연세의대 강남세브란스병원, 전문의