Retained foreign bodies including gossypiboma could be silent for years. However, in some cases, it can lead to major complications. Gossypiboma is not frequently reported for multiple reasons, including nonspecific presentation clinically and radiologically, and ethical issues. We present a case of a gossypiboma that was retained for more than 20 years causing a severe intestinal obstruction for an elderly female. The intestinal obstruction was initially thought to be adhesive in nature and was managed initially conservatively, but with failure to improve, the patient was taken for exploratory laparotomy, and the foreign body was found attached to the root of the mesentery posterior to the transverse colon. This case sheds light on the fact that although surgical tools are of great utility, they must be managed with utmost care to prevent complications and secure patients' safety.
Introduction
Primary malignant fibrous histiocytoma (MFH) of the breast is a rare condition that typically occurs in middle-aged women. Its presentation in older men is extremely rare, and there is very little information about primary MFH of the male breast.
Presentation of case
We present the case of a 55-year-old Yemeni man who presented with recurrent MFH of the right breast. Computed tomography revealed a large heterogeneous solid soft tissue mass within the right breast region that measured 6.7 cm × 8.4 cm × 11.9 cm in size, without axillary lymph node involvement. He was treated with radical mastectomy, adjuvant radiotherapy, and chemotherapy. The postoperative histopathological findings were indicative of grade 3 undifferentiated pleomorphic sarcoma of the breast.
Discussion
MFH originates from undifferentiated mesenchymal cells. Primary MFH of the breast is rare, and the most common sites are the limbs, trunk, retroperitoneum, bone, head, and neck. It has a high recurrence and metastasis rate, but lymph node involvement is not common. MFH is typically treated with surgery and radiotherapy, and the benefits of chemotherapy and routine axillary dissection are unclear.
Conclusion
MFH is an aggressive tumour with a high risk of recurrence and metastasis. Its differential diagnosis is mainly reliant on analysis of the histomorphological features of the tumour. The treatment plan should be based on the size of the tumour. Simple mastectomy with a wide margin and adjuvant radiotherapy is the most common strategy that has been found to be beneficial if no invasion to the muscle.
Highlights
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