A new complication of retained surgical gauze: development of malignant fibrous histiocytoma – report of a case with a literature review

Abstract

BackgroundPrimary visceral malignant fibrous histiocytoma (MFH) is a rare disease, and few cases have been reported in the English literature. However, retained foreign bodies in the abdomen after surgical procedures are important causes of intra-abdominal infections. For legal and ethical reasons, there are few publications in the literature. In this article, we describe for the first time a case of malign abdominal fibrous histiocytoma associated with a surgical sponge forgotten in the abdominal cavity a long time ago.Case presentationA 64-year-old male presented to our surgical department with cachexia, abdominal pain, distention and pyrexia of unknown origin. He had a medical history of abdominal surgery for peptic ulcer perforation 32 years ago. Clinical examination revealed fever with a distended and painful abdominal wall. Radiological imaging of the abdomen showed multiple heterogeneous masses in one large cystic cavityalmost completely filling the abdomen. The patient underwent a laparotomy, and interestingly, opening the cyst revealed retained surgical gauze (RSG). The origin of the tumor was the visceral peritoneum, and it was excised totally.ConclusionsPrimary intra-abdominal MFH can present as a complication of long-lasting RSG. Therefore, clinicians must remember this while establishing the differential diagnosis for patients with a history of previous abdominal surgery and presenting with symptoms associated with both the tumor and systemic inflammatory response.

Retained Surgical Gauze Swab Migration in a Paraplegic Patient: A Case Report and Literature Review

“…Rajkovi, et al described a case of gossypiboma discovered 40 years after index surgery as the cause for chronic lumbar back pain [6]. As a consequence of the inflammatory process introduced by retained surgical bodies, sarcomas developing from chronic inflammatory tissue have been reported throughout the literature [10][11][12]. In the presented case, the exudative process led to migration of surgical gauze to the distal medial thigh over a period of 15 years.…”

Retained Intra-Abdominal Hemostatic Materials: A Rare Cause of Abscess, Intestinal Obstruction, and Intestinal Fistula

“…Pain/irritation (42%), palpable mass (27%), and fever (12%) were the leading signs and symptoms but 6% of cases were asymptomatic [7]. Gossypiboma can present with foreign body granuloma, even as malignant fibrous histiocytoma [8], and also can cause serious complications such as perforation, intra-abdominal abscess, intestinal obstruction, and intestinal fistula [9,10].…”

Injection-site Malignant Fibrous Histiocytomas in a Pegvisomant Carcinogenicity Study in SD Rats

“…Although risk factors for MFH development in humans have not been well characterized, MFH appears more commonly in patients with prior exposure to ionizing radiation (especially radiation therapy for cancer of the head and neck; Clark et al 2011;Sturgis and Potter 2003). Isolated cases of MFH in humans associated with foreign bodies have also been reported (Kaplan and Lykosker 2012;Nishida et al 2005;Theegarten, Sardisong, and Philippou 1995). Reports of MFH in humans associated with SC injection of drugs were not found, and these are assumed to be rare if they occur at all.…”