Foreign Body Granuloma Presenting as a Lytic Lesion of the Ilium: A Case Report

Kyriakos Papavasiliou^1*, Sousana Panagiotidou¹, Nifon Gkekas¹, Savvas Mavromatidis², Stergios Adam¹ & Eleftherios Tsiridis¹

¹Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical School, Thessaloniki Ring Road West, Greece
²Operating Theaters, Surgical Sector, Papageorgiou General Hospital, Thessaloniki Ring Road West, Greece

Dr. Kyriakos Papavasiliou, Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical School, Thessaloniki Ring Road West, Greece.

Keywords: Foreign Body Granuloma; Gossypiboma; Ilium; Lytic Lesion; Tumorlike Lesion

Abstract

Foreign body granulomas, alternatively known as gossypibomas, may rarely mimic aggressive musculoskeletal tumors, both clinically and through imaging studies, potentially leading to unnecessary diagnostic and/or surgical interventions. A gossypiboma is a totally preventable, rather infrequent and under-reported complication, which may have serious medico-legal implications. It occurs due to an artificial material which was accidentally or intentionally retained in the surgical area. We report the case of 65-year-old patient, reporting constant pain for 3 years and imaging studies depicting a non-contained lytic lesion at her left ilium. A CT-guided biopsy was nondiagnostic. The patient had sustained a tibia fracture, operatively treated with internal fixation and instillation of autologous graft harvested from her left ilium. Based on history, physical examination and available imaging (revealing a radiopaque structure), the patient was diagnosed with a gossypiboma. She was operated on, leading to full recovery.

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