# Textiloma mimicking retroperitoneal sarcomatoid carcinoma: A case study of diagnostic and therapeutic challenges

## TL;DR

A case study shows how a forgotten surgical sponge can mimic a rare cancer, highlighting diagnostic and treatment challenges.

## Contribution

This case study highlights the rare occurrence of a textiloma in the retroperitoneum mimicking sarcomatoid carcinoma.

## Key findings

- A textiloma was misdiagnosed as a retroperitoneal sarcomatoid carcinoma based on imaging.
- Histopathological analysis confirmed the mass was a textiloma from a forgotten surgical sponge.
- Surgical removal resolved the issue, emphasizing the importance of accurate diagnosis.

## Abstract

textilomas, caused by forgotten surgical sponges, triggers inflammatory reactions, leading to complications like abscesses and fistulas. Often asymptomatic or presenting as an abdominal mass, they pose diagnostic challenges. This case study reports a textiloma mimicking a retroperitoneal sacromatoid carcinoma, discovered post-tumorectomy, and explores related diagnostic and therapeutic issues.

A 58-year-old woman with a history of ureterolithotomy presented with chronic lumbar pain, fever, and a right retroperitoneal mass. Clinical and biological examinations indicated an inflammatory syndrome. CT and MRI imaging revealed a well-defined cystic mass, suspected to be a sarcomatous tumor. Surgical removal of the mass followed oncological principles. Histopathological examination confirmed it was a textiloma, a reaction to a forgotten surgical sponge, with no malignancy.

a textiloma, or gossypiboma, is a rare postoperative complication caused by forgotten surgical sponges, is common in intraperitoneal and gynecological regions, it is rare retroperitoneally. Textilomas provoke acute inflammatory reactions leading to abscesses or chronic inflammation causing fibrosis and calcifications. Diagnosis is challenging due to non-specific clinical signs, often requiring radiological investigations. CT and MRI can reveal characteristic features like serpiginous centers and spongiform appearances. Surgical removal is necessary. Recovery is usually uncomplicated in 60 % of cases, though severe complications and deaths can occur in delayed interventions.

The medical history and imaging are crucial for diagnosing textilomas, whose incidence has decreased with radio-opaque marked sponges. Despite this, meticulous sponge counting remains essential but insufficient to completely eliminate the risk.