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)

Discussion

• 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)