FDG PET CT features of an intraabdominal gossypiboma

Retained surgical sponge or gossypiboma in the abdominal cavity is an infrequent but serious surgical complication that may lead to medicolegal problem. The incidence of a surgical sponge retained at operation is difficult to estimate, but it has been reported as 1 in 100 to 3000 for all surgical interventions and 1 in 1000 to 1500 for intraabdominal operations. The natural evolution of a retained sponge, if aseptic, is to cause a foreign body reaction, followed by organization to form a foreign body granuloma, which may mimic a soft tissue neoplasm. Although features of CT and MR imaging of gossypibomas have been documented in the literature, they have often been misinterpreted preoperatively owing to the rarity of gossypibomas in daily clinical practice and to the low index of clinical suspicion. We report the FDG PET CT findings of a 42-year-old woman who had undergone cesarean sections twice previously, with an intraabdominal gossypiboma found incidentally in a routine health examination. We hope the PET CT findings in this case offer us useful adjunctive information to conventional imaging studies in the diagnosis of gossypiboma.