Perirenal textiloma: MR and serial CT appearance

Abstract

We describe changes in imaging features of a textiloma (retained surgical sponge or retained foreign body) left in the renal fossa after exploratory renal surgery. One year after the initial surgery, the MR aspect of the textiloma was not specific, with a homogeneous low signal intensity on T1-weighted images. Serial CT examinations over 4 years demonstrated progressive growth and calcification of the mass which appeared pseudocystic with a peripheral inflammatory wall. Granulomas caused by a retained surgical sponge should be considered as a cause of retroperitoneal mass in patients with a history of prior surgery.

Intrarenal Foreign Body Presenting as a Renal Calculus

“…[3][4][5] However, such retained textilomas are obviously underreported mainly because of medical and legal problems. Presentation includes purulent cutaneous fistulae, renal and perirenal pseudotumors, and renal calculus formation.…”

“…Presentation includes purulent cutaneous fistulae, renal and perirenal pseudotumors, and renal calculus formation. [3][4][5][6][7][8][9][10][11] These foreign bodies can also remain asymptomatic for years and a proper follow-up with radiological evaluation can assist in the proper diagnosis previously to the ap- pearance of symptoms. 4 A high index of suspicion is important when evaluating a patient with previous surgery.…”

“…Radiology may contribute to the pre-operative diagnosis, especially when a radio-opaque marker is obvious, whereupon, conventional radiography may then allow for an accurate diagnosis. Otherwise, certain characteristic signs may be sought with ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) 5 . We describe a case of surgical gauze retained in the renal pelvis after an open renal surgery presenting as a renal calculus.…”

Giant Abdominal Cystic Textiloma Mimicking Hydatid Cyst

“…However, well-encapsulated pseudocystic forms with peripheral calcifications, mimicking mesenteric cysts, have been described. 3,5 Our observations are remarkable owing to the huge size of the pseudocyst, leading to spontaneous rupture into the stomach and the location in the left subphrenic space raising a number of differential diagnoses, including: 1) a cyst of the left lobe of the liver, ruled out by MRI multiplanar study; 2) exophytic cystic formation of the spleen of various origins (hydatid, epidermoid posttraumatic pseudocyst) suggested by the tight relationship of the mass to the anterior and medial surfaces of the spleen with no cleavage area seen on all imaging modalities; 3) either mucinous cystadenoma or pseudocyst of the tail of the pancreas, both of which were unlikely because the pancreas appeared separated from the cyst and pushed anteriorly and laterally to the right side; 4) mesenteric cyst, which was suggested by the large size of the cyst, presence of peripheral calcifications and displacement of all abdominal organs; and 5) retroperitoneal cyst, which was suggested by the forward displacement of the pancreatic tail and the downward displacement of the left kidney. However, the backward displacement of the spleen did not support this diagnosis.…”

“…Traditionally, textiloma produces a reticulated, textiform mass of mixed pattern, the appearance of which is highly suggestive on both plain abdomen radiograph and computerized tomography (CT) scan. [1][2][3] We report an atypical case of giant abdominal cystic textiloma mimicking a hydatid cyst arising from the spleen with spontaneous rupture into the stomach. …”