Yash Wagh, Rajeev Reddy, Manit Gundavda, Manish Agarwal
Department of Orthopaedic Oncology, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2020 Aug-Sep;10(5):12-15. doi: 10.13107/jocr.2020.v10.i05.1816.
Gossypiboma is an iatrogenic lesion, caused by a retained surgical sponge in the operating field. It is an extremely rare event following musculoskeletal procedures and has devastating medicolegal consequences. It is hardly ever reported, and hence, the incidence is difficult to determine.
We present a case report of a 70-year-old gentleman who presented with a painless swelling in the right thigh for 7 months. He had undergone open femoral nailing 10 years ago. Imaging studies suggested a soft-tissue sarcoma, but the biopsy was not conclusive. Intraoperatively, the mass was excised and found to have a thick fibrous wall with a gauze piece inside. Polarizing microscopy confirmed the diagnosis of gossypiboma.
Gossypiboma is an infrequent but devastating consequence of a human error. It is often difficult to diagnose and is confused with a soft-tissue sarcoma. Prevention of such untoward incidents by strict adherence to protocols is far better than cure.
医用海绵瘤是一种医源性病变，由手术区域遗留手术海绵引起。这是肌肉骨骼手术后极为罕见的事件，会产生严重的法医学后果。几乎没有相关报道，因此，其发病率难以确定。
我们报告一例70岁男性病例，其右大腿出现无痛性肿胀7个月。他10年前接受过股骨切开复位内固定术。影像学检查提示为软组织肉瘤，但活检结果不明确。术中切除肿块，发现其有一层厚厚的纤维壁，内部有一块纱布。偏振光显微镜检查确诊为医用海绵瘤。
医用海绵瘤是人为失误导致的罕见但严重的后果。它通常难以诊断，易与软组织肉瘤混淆。严格遵守操作规程以预防此类不良事件远比治疗要好。
