Textiloma in the brain in a patient with ganglioglioma after surgical treatment: а clinical case

Introduction: Retention of surgical tissue material in the skull, known as a gossipiboma or textiloma, is a rare but potentially serious complication following surgery. Although rare, such an event poses a significant risk, especially in complex surgical settings such as neurosurgery.

Objective: To determine the radiographic signs of foreign surgical tissue material after neurosurgery.

Materials and methods: We present a clinical case of an 8-year-old boy with ganglioglioma with tumor recurrence, in whom a foreign body, a gauze pad, was found in the structure of continued tumor growth during repeated surgery.

Results: The patient underwent surgery, during which, in addition to the removed tumor, a gauze pad was removed after previous surgical treatment and several courses of chemotherapy. In the postoperative period, an analysis of all available preoperative MRI images was performed, where, in addition to the tumor, a predominantly hypointense on T1-weighted images and hyperintense on T2-weighted images formation was detected, around which a thin homogeneous isointense rim was observed on T2-weighted MRI images, and demonstrating intense accumulation of contrast with pronounced limited diffusion, and which was the textileoma (gauze pad).

Conclusion: Postoperative visualization of the brain is a complex task. The final diagnosis of intracranial textiloma should be made after consultation with the operating neurosurgeon, and careful comparison of the images with preoperative images.

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