Puvanesarajah Varun, Fayad Laura M, Rao Sandesh S, McCarthy Edward F, Morris Carol D
Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Skeletal Radiol. 2019 Apr;48(4):629-635. doi: 10.1007/s00256-018-3059-5. Epub 2018 Sep 10.
A 70-year-old man with a history of bladder and colon cancer presented with an enlarging mass in his right lower extremity. Forty years before presentation, he had injured his right lower extremity in a motor vehicle accident. Imaging findings indicated suspected sarcoma, which led to biopsy. Biopsy and further surgical exploration revealed the presence of a surgical sponge and surrounding local inflammatory reaction. No neoplasm was found, and the sponge and involved tissues were removed. Gossypiboma is exceedingly rare in the extremities. Imaging of retained foreign material can appear suggestive of sarcoma because of strong inflammatory responses and local tissue mass-like derangement resulting in heterogeneous signal changes. Ultimately, biopsy must be performed to ensure that no oncological pathological condition is present.
一名有膀胱癌和结肠癌病史的70岁男性,右下肢出现一个不断增大的肿块。在出现症状的40年前,他在一次机动车事故中右下肢受伤。影像学检查结果提示疑似肉瘤,遂进行活检。活检及进一步的手术探查发现有一块手术海绵及周围局部炎症反应。未发现肿瘤,遂将海绵及受累组织切除。棉纤维瘤在四肢极为罕见。由于强烈的炎症反应和局部组织肿块样紊乱导致信号变化不均一,残留异物的影像学表现可能提示肉瘤。最终,必须进行活检以确保不存在肿瘤病理情况。