Gossypiboma of thigh mimicking soft tissue sarcoma: A case report and review of the literature

大腿棉球瘤酷似软组织肉瘤:病例报告及文献复习

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Abstract

INTRODUCTION AND IMPORTANCE: Gossypiboma is a term used to describe a surgical error related to accidental retention of surgical material within the body. Gossypibomas of extremities are rare and not only lead to serious health problems (infection and organ damage), but also, they may mimic benign or malignant tumors, especially those affecting the thigh where they may mimic soft tissue sarcomas. CASE PRESENTATION: A 50-year-old male, presented to the orthopedic department with a round palpable mass at mid-lateral of his right thigh region. The patient had history of surgical intervention on his femur due to femoral fracture 38-years ago. He had no sign of infection with normal laboratory workups. Radiological examinations suggested the possibility of a soft tissue sarcoma. Upon grossing, it revealed a white-tan and pink oval cystic mass with smooth surface. The cyst was filled with gauze fibers and creamy white-tan material. Histologically, the cystic wall of the mass revealed fibrocollagenous tissue, chronic inflammation and tiny foreign body materials, engulfed by the multinucleated giant cells, which was diagnosed as gossypiboma. CLINICAL DISCUSSION: Gossypiboma can mimic malignant soft tissue sarcomas. In most of the previously reported cases, the clinical and radiological findings suggested the possibility of malignant neoplasms. CONCLUSION: Considering the similarity between asymptomatic capsulated gossypiboma and soft tissue sarcomas radiologically, the possibility of gossypiboma should always be in the differential diagnosis, mainly in cases with presence of previous surgical scar or history of surgery at the affected area.

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