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

• Published in: Journal of neurological surgery reports 2020-01, Vol.81 (1), p.e7-e9
• Main Authors: Jaramillo-Jiménez, Esteban, Gupta, Manu, Snipes, George, Cheek, Brennen S., Michael, Christopher B., Navarro-Montoya, Ana M., Gómez-Escobar, Tatiana, Jiménez-Villegas, Juliana, Rodríguez-Márquez, Iader, Melguizo-Gavilanes, Isaac
• Format: Article
• Language: English
• Subjects: astrocytoma; Case Report; foreign body; local; neoplasm recurrence; textiloma
• ISSN: 2193-6358; 2193-6366
• DOI: 10.1055/s-0039-3400231

Abstract 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.