Gossypiboma-associated sarcomas in five cases

To report clinical presentation, treatment and outcome of dogs and cats diagnosed with gossypiboma-associated sarcoma.

Referral centres within the United Kingdom, Europe, North America and Australia were contacted to search medical records for dogs and cats with documented gossypiboma-associated sarcoma and included if comprehensive clinical records, histopathology and follow-up to death were available.

Four dogs and one cat were included. The surgical procedures where the surgical gauze was accidentally retained were ovariohysterectomy (n = 4) and caesarean section (1). Time between this surgery and gossypiboma-associated sarcoma diagnosis ranged from 1054 to 2201 days. Presenting clinical signs included anorexia (n = 5), lethargy (3), vomiting (2) and abdominal pain (2). Preoperative imaging documented an abdominal mass with no evidence of metastases in all cases. Surgical procedures to facilitate mass excision included duodenectomy (n = 1), partial pancreatectomy (1), partial gastrectomy (1), omentectomy (1) and ovariohysterectomy (1). Histopathology results were consistent with gossypiboma-associated fibrosarcoma (n = 2), extraskeletal osteosarcoma (1), hemangiosarcoma (1) and poorly differentiated sarcoma (1), with all demonstrating chronic granulomatous inflammation with intralesional refractile fibre foreign material. One received adjuvant chemotherapy postoperatively. Lesions consistent with metastasis were identified on imaging in three dogs and one cat and suspected in one dog, between 11 and 114 days postoperatively. Survival time from surgery for cases 1 to 5 was 181, 56, 66, 13 and 196 days, respectively.

Gossypiboma-associated sarcomas are rare and exhibit aggressive clinical behaviour with a generally poor prognosis. Use of radiopaque surgical gauzes, surgical checklists and surgical gauze counts are imperative to prevent such neoplasms.