Case of a giant gauzeoma diagnosed 21 years after an inguinal hernia surgery / Journal of Rural Medicine

Objectives: Gauze remnants form gauzeomas after surgery, if infection has not occurred. We present a case of gauzeoma diagnosed after surgery.Patient: A 72-year-old man noticed a mass in his lower abdomen. He had undergone surgery for left inguinal hernia 21 years ago. A retroperitoneal mass was found on computed tomography (CT) and magnetic resonance imaging (MRI), and he was then referred to our hospital. A detailed abdominal ultrasonography, CT, and MRI revealed a cystic mass with a bulkhead-like structure near the bladder. These findings indicated the possibility of a malignant cyst; hence, an open surgery was performed to excise the mass. Macroscopically, the specimen was clearly bound, covered with a capsule, and filled with pus and had a gauze inside.Results: Based on the patient history and position of the mass, it was diagnosed as gauzeoma, which had strayed into the retroperitoneal cavity during the surgery for inguinal hernia.Conclusion: The imaging findings of gauzeoma are diverse; hence, it is often difficult to diagnose without surgery. However, gauzeoma can be lethal if the cystic mass is infected; thus, it is important to diagnose it correctly.

Therapeutic results in elderly patients with prostate cancer: chronologicalcomparison in a single community hospital / Journal of Rural Medicine

<p><b>Objective:</b> There are few reports of the long-term outcomes of elderlypatients with prostate cancer. We analyzed data from our institution from the past 12years, including the patient history, treatment methods, and prognosis of patients withprostate cancer aged 80 years or more.</p><p><b>Patients and Methods:</b> A total of 179 cases of prostate cancer in patientsaged 80 years or more were retrospectively evaluated. We divided them chronologically intogroups A, B, C, and D: Group A included 40 cases from 2002–2004; Group B, 48 cases from2005–2007; Group C, 46 cases from 2008–2010; and Group D, 45 cases from 2011–2013.</p><p><b>Results:</b> Sixty-one (30%) patients changed treatment course. Interestingly,no cancer deaths occurred in the patients who changed treatment course. Although 14 (7.8%)cancer deaths occurred (A: B: C: D = 4: 4: 6: 0, respectively), all occurred in 2011 orlater.</p><p><b>Conclusion:</b> In our study, over 50 patients who underwent treatment survivedfor 5 years or more. By treating prostate cancer in elderly patients when appropriate, wecan lower the mortality rate due to prostate cancer. Our results support the activetreatment of prostate cancer in elderly patients.</p>