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INTRODUCTION: textilomas, caused by forgotten surgical sponges, triggers inflammatory reactions, leading to complications like abscesses and fistulas. Often asymptomatic or presenting as an abdominal mass, they pose diagnostic challenges. This case study reports a textiloma mimicking a retroperitoneal sacromatoid carcinoma, discovered post-tumorectomy, and explores related diagnostic and therapeutic issues. CASE REPORT: A 58-year-old woman with a history of ureterolithotomy presented with chronic lumbar pain, fever, and a right retroperitoneal mass. Clinical and biological examinations indicated an inflammatory syndrome. CT and MRI imaging revealed a well-defined cystic mass, suspected to be a sarcomatous tumor. Surgical removal of the mass followed oncological principles. Histopathological examination confirmed it was a textiloma, a reaction to a forgotten surgical sponge, with no malignancy. DISCUSSION: a textiloma, or gossypiboma, is a rare postoperative complication caused by forgotten surgical sponges, is common in intraperitoneal and gynecological regions, it is rare retroperitoneally. Textilomas provoke acute inflammatory reactions leading to abscesses or chronic inflammation causing fibrosis and calcifications. Diagnosis is challenging due to non-specific clinical signs, often requiring radiological investigations. CT and MRI can reveal characteristic features like serpiginous centers and spongiform appearances. Surgical removal is necessary. Recovery is usually uncomplicated in 60 % of cases, though severe complications and deaths can occur in delayed interventions. CONCLUSION: The medical history and imaging are crucial for diagnosing textilomas, whose incidence has decreased with radio-opaque marked sponges. Despite this, meticulous sponge counting remains essential but insufficient to completely eliminate the risk.
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INTRODUCTION AND IMPORTANCE: Advances in medical imaging have led to increased detection of rare adrenal cysts, typically asymptomatic. The article emphasizes their silent nature and the evolving diagnostic methods. CASE PRESENTATION: Woman underwent successful laparoscopic removal of a 9 cm left adrenal cyst. Histological analysis identified it as an endothelial cyst. CLINICAL DISCUSSION: Adrenal cysts, mostly unilateral, have diverse histological types. Diagnosis relies on imaging, and surgical intervention is required for symptomatic cases or those exceeding 5 cm. Minimally invasive techniques have improved outcomes. CONCLUSIONS: Adrenal cysts, generally benign and asymptomatic, pose diagnostic challenges. Surgical intervention is recommended for larger or symptomatic lesions, with advancements in minimally invasive options improving outcomes.
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Sarcomatoid carcinomas of the bladder represent a tiny part of bladder tumors and are characterized by a high potential for malignancy. Very aggressive and affecting mainly men, these tumors present both a urothelial and sarcomatoid contingent. The treatment of these tumors is not well codified given the rarity of cases reported in the literature, however, it seems that the treatment is essentially based on radical cystectomy with extensive pelvic lymph node dissection. We report the experience of our departement in the management of this type of tumor in a series of five cases collected over a period of 8 years.