A conundrum wrapped in gauze: a case report of intracranial gossypiboma

Abstract Background Gossypiboma refers to a retained intracavitary foreign object comprising of resorbable or non-absorbable cotton or textile matrix that is left behind accidentally or deliberately during surgery, together with the adjacent inflammatory reaction. There are only very few case reports of intracranial gossypibomas. Case Presentation A 58-year-old male patient of arteriovenous malformation (AVM), operated 6 months prior presented with a headache of 1 month’s duration followed by a solitary seizure. On imaging, a well-circumscribed ovoid lesion was discovered at the surgical site and a diagnosis of AVM aneurysm was made. However, per-operative findings revealed the culprit lesion to be a retained surgical sponge. Conclusions Gossypiboma mimics a variety of pathologies like postoperative collection or residual/recurrent mass lesions. The treatment can be varied from conservative management to re-exploration surgery. Therefore, when encountered with a well-defined mass-like lesion in a postoperative site, the possibility of an intracranial gossypiboma must always be considered.