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腿部纺织瘤。病例报告。

Leg textiloma. A case report.

作者信息

Mouhsine Elyazid, Garofalo Raffaele, Cikes Alec, Leyvraz Pierre François

机构信息

Department of Orthopaedic Surgery and Traumatology, University Hospital, Lausanne, Switzerland.

出版信息

Med Princ Pract. 2006;15(4):312-5. doi: 10.1159/000092998.

Abstract

OBJECTIVE

To report and highlight the potential diagnostic pitfalls and consequences of leg textiloma.

CASE REPORT AND INTERVENTION

A soft tissue pseudotumor of the left leg diagnosed in a 58-year-old man is described. The lesion was caused by a retained surgical gauze after surgery for varicose veins. The surgical gauze had remained in the subcutaneous tissue for 3 years and led to the formation of a 3-cm, well-circumscribed, pseudotumoral foreign body granuloma which appeared like a soft tissue tumor. A surgical intervention was performed and the mass was excised. During the procedure an old surgical gauze was found. The histologic examination revealed that a large foreign body granuloma (pseudotumor) had developed in contact with foreign material birefracting under polarized light (gauze). No sign of malignancy was noted.

CONCLUSION

Although no fatal complications have been described in the musculoskeletal localization, the diagnosis is difficult and costly. According to clinical presentation, a differential diagnosis should be made between a tumoral lesion, such as a sarcoma, or a pseudotumoral lesion, such as a gossypiboma. Focal myositis or infections should also be suspected.

摘要

目的

报告并强调腿部纺织瘤潜在的诊断陷阱及后果。

病例报告与干预措施

描述了一名58岁男性左腿软组织假瘤的情况。该病变由静脉曲张手术后残留的手术纱布引起。手术纱布在皮下组织中存留了3年,导致形成一个3厘米、边界清晰的假瘤样异物肉芽肿,看起来像软组织肿瘤。进行了手术干预并切除了肿块。手术过程中发现了一块陈旧的手术纱布。组织学检查显示,与在偏振光下呈现双折射的异物(纱布)接触处形成了一个巨大的异物肉芽肿(假瘤)。未发现恶性迹象。

结论

尽管在肌肉骨骼部位尚未描述有致命并发症,但诊断困难且成本高昂。根据临床表现,应在肿瘤性病变(如肉瘤)或假瘤性病变(如棉纤维瘤)之间进行鉴别诊断。还应怀疑局灶性肌炎或感染。

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