Textiloma Mimicking a Recurrent High-Grade Astrocytoma: A Case Report

Abstract

Introduction Textiloma (Txm) is a nonmedical term that has been given to foreign body-related inflammatory pseudotumor arising from retained nonabsorbable cotton matrix that is either inadvertently or deliberately left behind during surgery, which may trigger an inflammatory reaction. This report describes a case of Txm mimicking a recurrent high-grade astrocytoma.

Case Report We, here, present the case of a 69-year-old female with a 6-month history of progressive left-sided weakness. Neuroimaging studies revealed a large nonenhancing mass in the right frontoparietal lobe. Pathology reported a World Health Organization tumor classification grade II, diffuse astrocytoma. After surgical intervention, external beam radiation was given to the remaining areas of residual tumor. Routine magnetic resonance imaging (MRI) revealed a nodular area of contrast enhancement in the dorsal and inferior margin of the biopsy tract, growing between interval scans, and perfusion-weighted imaging parameters were elevated being clinically asymptomatic. She underwent a complete resection of this area of interest and pathology returned as a Txm with Surgicel fibers.

Conclusion After treatment of a neoplasm, if unexpected clinical or imaging evidence of recurrence is present, a foreign body reaction to hemostatic material used during the initial surgery should be included in the differential diagnosis.

Keywords

foreign body - astrocytoma - neoplasm recurrence - local - textiloma

• References

• 1 Ribalta T, McCutcheon IE, Neto AG. , et al. Textiloma (gossypiboma) mimicking recurrent intracranial tumor. Arch Pathol Lab Med 2004; 128 (07) 749-758
• 2 Peloquin P, Vannemreddy PSSV, Watkins LM, Byrne RW. Intracranial cotton ball gossypiboma mimicking recurrent meningioma: report of a case with literature review for intentional and unintentional foreign body granulomas. Clin Neurol Neurosurg 2012; 114 (07) 1039-1041
• 3 Melguizo-Gavilanes I, Bruner JM, Guha-Thakurta N, Hess KR, Puduvalli VK. Characterization of pseudoprogression in patients with glioblastoma: is histology the gold standard?. J Neurooncol 2015; 123 (01) 141-150
• 4 Aydogan M, Mirzanli C, Ganiyusufoglu K, Tezer M, Ozturk I. A 13-year-old textiloma (gossypiboma) after discectomy for lumbar disc herniation: a case report and review of the literature. Spine J 2007; 7 (05) 618-621
• 5 Bilginer B, Yavuz K, Agayev K, Akbay A, Ziyal IM. Existence of cotton granuloma after removal of a parasagittal meningioma: clinical and radiological evaluation -a case report-. Kobe J Med Sci 2007; 53 (1,2): 43-47