A gossypiboma (foreign body granuloma) mimicking a residual odontogenic cyst in the mandible: a case report

Abstract

IntroductionGossypiboma (foreign body granuloma) in the tooth socket as a complication of tooth removal is rare. Several cases of gossypiboma have been reported after orthopedic, abdominal, otorhinolaryngology, or plastic surgery, but there has been only one reported case after oral surgery.Case presentationA 42-year-old Caucasian German-speaking Swiss woman applied to our clinic for removal of her right mandibular first molar. Her right mandibular third molar had been removed seven years ago. Post-operatively, she complained of pain and foreign body sensation for six months in the area of the removed tooth. A panoramic radiograph of our patient showed a defined and oval radiolucent area in the socket of the right mandibular third molar evoking a residual cyst. An operation was planned to remove the cyst-like lesion. During surgery, a foreign body composed of gauze was found in the right mandibular third molar region. The histological findings were compatible with a foreign body reaction around gauze.ConclusionRetained gauze must be considered if patients complain of pain and foreign body sensation after tooth removal. The use of gauze with radio-opaque markers and extensive irrigation of the socket with saline to remove gauze fragments can avoid this mishap.

Gossypiboma following mandible surgery: a case report and review of the literature

“…Gossypiboma is a term derived from the Latin word ‘gossipium’, which means ‘cotton’, and the Swahili word ‘boma’, which means ‘place of concealment’. It refers to an iatrogenic mass lesion caused by inadvertent retention of surgical sponges at the operative site.…”

“…Gossypibomas can mimic neoplasms and space‐occupying mass lesions which may cause some difficulties in diagnosis. The differential diagnosis should be based on the clinical history of each case and should include but not be limited to the following: tumours, radiation necrosis, abscess, haematoma and foreign‐body reactions.…”

“…Gossypiboma has rarely been reported in relation with mandible surgery, probably because of the relatively small size of the surgical field. Only five cases have been published so far: three after mandibular contouring operations, one after submandibular sialadenectomy and one after third molar extraction. Of all the reported cases, four were females and one was a male.…”

“…Gossypiboma (or texitiloma) is the term used to describe a mass within the body that is composed of cotton (gauze) and surrounded by a foreign‐body reaction. Gauze and surgical sponges are the most common form of retained foreign bodies after surgical procedures.…”

“…To the best of our knowledge, only seven cases have so far been reported in relation to the facial bones, of which five were in the mandible, one in the maxillary sinus and one in the frontal bone.…”