Gossypiboma of the Thigh Mimicking Soft Tissue Sarcoma: Case Report and Review of Literature

INTRODUCTION: Foreign body granulomas due to surgical swab left after surgery (Gossypiboma) are rare. There are few cases of such lesion after orthopaedic procedure in thigh. Presentations vary from pathological fracture to painless mass. Gossipyboma with radiological appearance of soft tissue sarcoma are rare and we report one such case CASE REPORT: 32 year old male laborer had fracture shaft femur 13 years back which went into malunion after conservative treatment. Osteoclasis, open reduction and K-nailing was done at 6 months. Fracture united and K nail was removed 3 years later. Patient was asymptomatic for 10 years after which he presented to us with swelling and pain in the medial aspect of thigh. Radiograph showed soft tissue mass with excavating lesion of the posteromedial aspect of femur resembling soft tissue sarcoma. Biopsy revealed cystic lesion with sterile fluid with no malignant cells. Explorations of the lesion lead to discovery of shredded surgical swab. Complete removal of all granulomatous tissue was done and patient was given hip spica for 3 months after which he was gradually mobilized and is currently walking full weight bearing at one year follow up. CONCLUSION: Cases with radiologically destructive lesions close to previous surgery scars should be assessed with gossypiboma as one of the differentials.