Delayed Retroperitoneal Textiloma 10 Years after Varicocelectomy: A Case Report and Literature Review

Abstract Introduction and Importance: Textiloma, also known as gossypiboma, is a rare yet significant surgical complication involving a retained surgical textile material. These foreign bodies can incite chronic inflammation or present as mass lesions long after the index surgery. Presentation of Case: We report a case of a 51-year-old male presenting with right-sided abdominal discomfort 10 years after undergoing a right varicocelectomy. Imaging revealed a 10 cm retroperitoneal mass. Laparoscopic exploration and excision confirmed a cystic lesion containing two retained surgical gauzes. Pathology identified a fibrous-walled cyst containing foreign body granulomatous inflammation. This case has been reported in line with the SCARE criteria. Clinical Discussion: Retroperitoneal textilomas are uncommon and may mimic other cystic or tumoral pathologies, including hydatid cysts or neoplasms, leading to diagnostic uncertainty. Imaging findings are often non-specific, and a history of prior surgery may be the only clue to diagnosis. Surgical exploration is frequently required for both confirmation and treatment. This case emphasizes the importance of maintaining a high index of suspicion in patients presenting with atypical abdominal masses and a remote surgical history. Conclusion: This case highlights the diagnostic challenge of retroperitoneal textiloma and underscores the importance of preventive strategies. Surgical resection remains the mainstay of treatment for definitive diagnosis and management. Keywords: Gossypiboma, Textiloma, Retroperitoneal mass, Varicocelectomy, Case report.