A calcified pelvic gossypiboma remaining clinically silent for 46 years and mimicking a degenerated uterine leiomyoma

Abstract

Gossypiboma is a retained surgical sponge that may remain asymptomatic for decades and mimic pelvic tumours. We report a pelvic gossypiboma presenting as a calcified uterine mass 46 years after a caesarean section; to our knowledge, the longest reported interval to diagnosis of gossypiboma of any aetiology. A 74-year-old woman undergoing staging computed tomography for caecal adenocarcinoma was found to have a 4-cm pelvic mass with peripheral eggshell-like calcification adjacent to the uterine fundus, initially diagnosed as a degenerated leiomyoma. The mass, incarcerated between the caecum and uterus, was resected during ileocaecal resection and found to contain a calcified capsule enclosing foreign fibres; histology and polarized light microscopy confirmed retained surgical material. Unlike most reported gossypibomas, the lesion lacked the characteristic spongiform or reticulated calcification pattern. Gossypiboma should be considered in atypically calcified pelvic masses, regardless of the interval since surgery.