An Unusual Malignant Appearance of Gossypiboma : Case Report

Tahsin Batuhan Aydoğan, Eymen Gazel, Mehmet Yörübulut, Mehmet Ezer and Lütfi Tunç

Department of Urology, Hacettepe University School of Medicine, Turkey
Department of Urology, Acıbadem University, Ankara Hospital, Turkey
Department of Radiology, Acıbadem University, Ankara Hospital, Turkey
Department of Urology, Gazi University School of Medicine, Turkey

^*Correspondance to: Eymen Gazel 

 PDF  Full Text DOI: 10.25107/2474-1647.1939

Abstract

Objectives: The aim of this case presentation was to show a case of an unusual malignant appearance of gossypiboma on Magnetic Resonance Imaging (MRI) of the patient whom had a robotic laparoscopic surgery.Methods: A 38 year old woman with no known co-existing health problems had left open nephrolithotomy 10 years ago in another country. During her asymptomatic period an ultrasound for the control of existing nephrolithiasis history defined an incidentally heterogeneous mass including calcification and malign features of vascularization. A 4.7 cm × 4.5 cm × 5.3cm peripherally thick and irregular rim contrast uptake with a central weak contrast uptake sarcomatous mass was showed on post-Intravenous Contrast Material injected (IVCM) images of abdominal MRI. The solid mass was consisted with a peripherally fibro-vascular, a centrally necrotic-hypovascular areas respectively. A robotic partial nephrectomy was performed and during the operation the mass was obviously a gossypiboma which had malign patterns of neovascularization and contrast enhancement. The renal parenchyma was spared, and the gossypiboma was resected successfully. The specimen was then sent to the pathology department. The pathology report described a yellow-brown necrotic fatty tissue with histiocytic reaction including a foreign body composed of textile-cotton fragments inside.Results and
Conclusion: To date, the exact prevalence of gossypiboma is unknown due to malpractice claims and medicolegal problems. Therefore, there is an extremely limited literature concerning the follow-up periods of these patients. Although malignancy is a differential diagnosis for gossypibomas, our case report is unique due to the long asymptomatic period observed in the patient.

Keywords

Gossypiboma; Robotic surgery; Laparoscopy; Nephrectomy; Renal cancer

Cite the article

Aydo?an TB, Gazel E, Y�r�bulut M, Ezer M, Tun� L. An Unusual Malignant Appearance of Gossypiboma : Case Report. Clin Surg. 2018; 3: 1939.