Journal of Neurological Surgery Reports (Jan 2020)

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

  • Esteban Jaramillo-Jiménez,
  • Manu Gupta,
  • George Snipes,
  • Brennen S. Cheek,
  • Christopher B. Michael,
  • Ana M. Navarro-Montoya,
  • Tatiana Gómez-Escobar,
  • Juliana Jiménez-Villegas,
  • Iader Rodríguez-Márquez,
  • Isaac Melguizo-Gavilanes

DOI
https://doi.org/10.1055/s-0039-3400231
Journal volume & issue
Vol. 81, no. 01
pp. e7 – e9

Abstract

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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.

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