Expansively Hemorrhagic Foreign Body Granuloma at the Pelvis Caused by Microscopic Materials

Masatoshi Morimoto, Mitsuhiko Takahashi, Nori Sato, Toshihiko Nishisho, Seiko Kagawa, Eiji Kudo, Shoichiro Takao, Natsuo Yasui

Department of Human Pathology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan.
Department of Orthopaedic Surgery, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan.
Department of Radiology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan..

DOI: 10.4236/ojo.2012.21001                

Abstract

A foreign body granuloma is a mass lesion consisting of a foreign body with host reaction. Its diagnosis is not always easy in respect of its similarity to soft tissue sarcoma. The most common foreign body is surgical sponge which can be detectable macroscopically. We present a foreign body granuloma in the left buttock caused by microscopic surgical materials that developed into a large lesion. An 80-year-old man with a history of surgery for dislocation of the left hip 20 years earlier, presented with a slowly growing mass that had expanded rapidly over the preceding 2 months. Histological examination revealed organizing granulation tissue surrounding the scattered foreign materials. One should be aware of foreign body granuloma at previously operated sites even without a retained macroscopic gauze sponge.

Keywords

Expanding Hematoma; Foreign Body Granuloma; Histologic Examination; Magnetic Resonance Imaging

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	B. Mboti, M. Gebhart, D. Larsimont and K. Abdelkafi, “Textiloma of the Thigh Presenting as a Sarcoma,” Acta Orthopaedica Belgica, Vol. 67, No. 5, 2001, pp. 513-518.
[2]	K. Sakayama, T. Fujibuchi, Y. Sugawara, et al., “A 40-Year-Old Gossypiboma (Foreign Body Granuloma) Mimicking a Malignant Femoral Surface tumor,” Skeletal Radiology, Vol. 34, No. 4, 2005, pp. 221-224. doi:10.1007/s00256-004-0821-7
[3]	D. F. Kalbermatten, N. T. Kalbermatten, R. Hertel, “Cotton-Induced Pseudotumor of the Femur,” Skeletal Radiology, Vol. 30, No. 7, 2001, pp. 415-417. doi:10.1007/s002560100358
[4]	C. Wilson, “Foreign Bodies Left in the Abdomen after Laparotomy,” Gynecologic Treatment, Vol. 9, 1884, pp. 109-112.
[5]	G. Fink, P. Herskovitz, M. Nili, et al., “Suture Granuloma Simulating Lung Neoplasm Occurring after Segmentectomy,” Thorax, Vol. 48, No. 4, 1993, pp. 405-406. doi:10.1136/thx.48.4.405
[6]	E. Mouhsine, R. Garofalo, A. Cikes and P. F. Leyvraz, “Leg Textiloma. A Case Report,” Medical Principles and Practice, Vol. 15, No. 4, 2006, pp. 312-315. doi:10.1159/000092998
[7]	Y. Tsuchida and T. Oyamada, “Experimental Pathological Study on the Postoperative Suture Granuloma in Rats,” Journal of the Japan Veterinary Medical Association, Vol. 61, No. 11, 2008, pp. 873-839
[8]	S. R. Kim, H. K. Baik and Y. W. Park, “Retained Surgical Sponge Presenting as a Pelvic Tumor after 25 Years,” International Journal of Gynecology & Obstetrics, Vol. 82, No. 2, 2003, pp. 223-225. doi:10.1016/S0020-7292(03)00139-5
[9]	R. Kobayashi, T. Fukui, A. Tatematsu, Y. Yatabe and T. Mitsudomi, “A Suture Granuloma of the Lung That Occurred 19 Years after Surgery for Mucoepidermoid Tumor,” Journal of the Japanese Association for Chest Surgery, Vol. 23, No. 2, 2009, pp. 165-168. doi:10.2995/jacsurg.23.165
[10]	M. Kominami, A. Fujikawa, T. Tamura, Y. Naoi and O. Horikawa, “Retained Surgical Sponge in the Thigh: Report of the Third Known case in the Limb,” Radiation Medicine, Vol. 21, No. 5, 2003, pp. 220-222
[11]	M. O. McCarron and J. A. Nicoll, “Cerebral Amyloid Angiopathy and Thrombolysis-Related Intracerebral Haemorrhage,” Lancet Neurology, Vol. 3, No. 8, 2004, pp. 484-492. doi:10.1016/S1474-4422(04)00825-7
[12]	L. Kopka, U. Fischer, A. J. Gross, et al., “CT of Retained Surgical Sponges (Textilomas): Pitfalls in Detection and Evaluation,” Journal of Computer Assisted Tomography, Vol. 20, No. 6, 1996, pp. 919-923. doi:10.1097/00004728-199611000-00009
[13]	A. I. Okten, M. Adam, Y. Gezercan, “Textiloma: A Case of Foreign Body Mimicking a Spinal Mass,” European Spine Journal, Vol. 15, No. S5, 2006, pp. m626-629. doi:10.1007/s00586-006-0136-6
[14]	T. Nishida, N. Nishiyama, Y. Kawata, et al., “Mediastinal Malignant Fibrous Histiocytoma Developing from a Foreign Body Granuloma,” Japanese Journal of Thoracic and Cardiovascular Surgery, Vol. 53, No. 10, 2005, pp. 583- 586. doi:10.1007/s11748-005-0074-y
[15]	T. A. Jennings, L. Peterson, C. A. Axiotis, et al., “Angiosarcoma Associated with Foreign Body Material. A Report of Three Cases,” Cancer, Vol. 62, No. 11, 1988, pp. 2436-2444. doi:10.1002/1097-0142(19881201)62:11<2436::AID-CNCR2820621132>3.0.CO;2-J