Fibromatosis mesentérica solitaria. Reporte de caso y revisión de la literatura / Sporadic mesenteric fibromatosis. A case report. Literature review / Fibromatose mesentérica solitária. Relato de caso. Revisão da literatura

Resumen: La fibromatosis mesentérica es un subtipo profundo de tumor desmoide (TD), un tumor benigno de origen fibroblástico localmente agresivo por su tendencia a infiltrar los tejidos adyacentes. Son raros, esporádicos y pueden asociarse con el síndrome de Gardner. El tratamiento de elección es la resección completa, evitando la recurrencia local. Comunicamos el caso clínico de una paciente con fibromatosis intrabdominal mesentérica única, bien circunscripta, que simulaba por la imagenología una masa de origen pelviano.

Summary: Mesenteric fibromatosis is a deep sub-type of desmoid tumors consisting of a benign tumor of fibroblastic origin which is locally aggressive given its tendency to infiltrate adjacent tissues. They are unusual and sporadic, and may be associated to Gardner's Syndrome. Complete resection is the treatment of choice, avoiding local recurrence. The study reports the clinical case of a patient with intra-abdominal sporadic mesenteric fibromatosis, well circumscribed that appeared to be a pelvic mass in MR imaging.

Resumo: A fibromatose mesentérica é um subtipo profundo de tumor desmóide (DT); é um tumor benigno de origem fibroblástica que é localmente agressivo devido à sua tendência a infiltrar tecidos adjacentes. São raros, esporádicos e podem estar associados à síndrome de Gardner. O tratamento de escolha é a ressecção completa, evitando recidiva local. Relatamos o caso clínico de uma paciente com fibromatose mesentérica intra-abdominal única e bem circunscrita que simulava uma massa de origem pélvica na imagem.

Hepatic Cystadenocarcinoma presenting as an ovarian new growth in a 65‐year‐old female: Case report

@#Biliary cystic tumors (BCT), which include the subgroups biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC), affect 5 to 10% of the global population. BCTs are solitary, multiloculated cysts that are usually intrahepatic in location. BCACs are rare tumors that arise from the malignant transformation of BCA. The presentation of BCT often mimics simple hepatic cysts and other hepatic cystic lesions making diagnosis difficult. With the recent advances in medical imaging, BCTs have been diagnosed more often. Patients with BCT are often asymptomatic. When symptoms are present, however, patients usually manifest with abdominal pain and distention. Given the high risk of recurrence, complete surgical resection by formal hepatic resection or enucleation is the best treatment of choice for patients. We present a case of a 65-year-old female who came in due to a four-year history of an enlarging abdomen. She was initially treated, preoperatively, as a case of ovarian new growth but was later managed as hepatic cystadenocarcinoma.

Quiste enterogénico y agenesia renal en la edad adulta / Enterogenic cyst and renal agenesis in adulthood

Introducción: Los quistes enterogénicos son malformaciones producidas durante el período de diferenciación y desarrollo embriológico del intestino primitivo. Objetivo: Presentar una malformación digestiva infrecuente en la edad adulta. Caso clínico: Paciente de 58 años que acude por dolor abdominal y aumento de volumen en hipogastrio. Al examen físico se palpa masa en hipogastrio de 15 cm de diámetro. La tomografía axial computarizada simple y contrastada mostró una masa tumoral en la excavación pélvica hipodensa con densidad de 18 UH, pared gruesa, de 2 cm, que realza con el contraste y agenesia renal derecha. El estudio anatomo-patológico informa quiste enterogénico. Discusión: La clínica de las duplicaciones intestinales es inespecífica, el dolor abdominal recurrente y la presencia de masa abdominal, son frecuentes. El diagnóstico preoperatorio de las duplicaciones intestinales es infrecuente, depende de la disponibilidad de estudios de imagen y la sospecha clínica. Es infrecuente la asociación de quiste enterogénico y agenesia renal. Conclusión: Se presenta una paciente masculino con una masa pélvica de etiología dudosa y agenesia renal derecha, en el que se diagnosticó un quiste enterogénico. La asociación de quiste enterogénico y agenesia renal es una malformación rara en el adulto(AU)

Introduction: Enterogenic cysts are malformations produced during the period of differentiation and embryological development of the primitive intestine. Objective: To report an rare digestive malformation in adulthood. Clinical case report: A 58-year-old patient came for abdominal pain and increased volume in the hypogastrium. On physical examination, a 15-cm diameter mass was palpated in the hypogastrium. Simple and contrast computerized axial tomography showed a tumor mass in the hypodense pelvic excavation with a density of 18 HU, a thick wall of 2 cm, which was enhanced with contrast and right renal agenesis. The anatomo-pathological study reports an enterogenic cyst. Discussion: The symptoms of intestinal duplications are nonspecific, recurrent abdominal pain and the presence of an abdominal mass are frequent. The preoperative diagnosis of intestinal duplications is occasional, it depends on the availability of imaging studies and clinical suspicion. The association of enterogenic cyst and renal agenesis is uncommon. Conclusion: A male patient is reported, with a pelvic mass of doubtful etiology and right renal agenesis, in whom an enterogenic cyst was diagnosed. The association of enterogenic cyst and renal agenesis is a rare malformation in adults(AU)

Delivering a female with missing cervix: a case report

Authors received a case in our casualty, 26 years old, G2P1L1, with full term pregnancy, spontaneous conception, previous normal vaginal delivery, with labour pain. On evaluation, she was having uterine contraction, fetal heart rate normal, vitally stable, with no cervix on per speculum and per vaginal examination, with solid globular mass per rectum. She was shifted to emergency operation theatre with provisional diagnosis of uterine rupture or rectal perforation or pelvic mass. After delivering a live baby, uterus was intact, but there was an impacted mass in pouch of Douglas, it was a twisted ovarian mass, sent for histopathology examination. Post-operative period was uneventful, and patient was discharged with healthy baby with corrected pelvic anatomy.

Masa pélvica en la mujer puérpera. Presentación de caso / Pelvic mass in puerperal woman. Case presentation

El término infección puerperal se utiliza para describir cualquier infección bacteriana del aparato genital después del parto. Durante gran parte del siglo XX las infecciones puerperales, la preeclampsia y la hemorragia obstétrica formaron parte de la tríada letal de mortalidad materna. La ecografía, la resonancia magnética y la tomografía axial computarizada son la triada de elección para el diagnóstico del abdomen agudo en el puerperio. El mismo resulta difícil debido a factores intrínsecos y es entonces, cuando el radiólogo adquiere un papel crucial. Se presentó un caso de una mujer de 30 años, con 8 días de habérsele practicado una cesárea con un puerperio inmediato normal. Posteriormente presentó dolor abdominal, fiebre, escalofríos y masa palpable en fosa iliaca izquierda. Se practicaron técnicas de imágenes se plantea una masa ovárica izquierda, se realizó laparotomía exploradora y se concluyó como absceso ovárico (AU).

The term puerperal infection is used to describe any bacterial infection of the genital tract after delivery. During much of the twentieth century puerperal infections, preeclampsia and obstetric hemorrhage were part of the lethal triad of maternal mortality. Ultrasonography, magnetic resonance imaging and computed tomography are the triad of choice for the diagnosis of acute abdomen in the puerperium, which is difficult due to intrinsic factors and it is when radiologist plays a vital role. The authors present the case of a woman, aged 30 years, at the 8th day after undergoing a cesarean section with a normal immediate puerperium, who later presented abdominal pain (AU).

Pelvic tuberculosis: from millets to masses

An adnexal mass is a common entity in the reproductive age group. Ovarian masses form a majority of this condition. Tuberculosis is a disease commonly encountered in the Tropics and is endemic to India. Abdominopelvic affliction of this disease is common in women especially in the reproductive age groups. It may present with variety of non-specific clinical features and often poses an enormous diagnostic dilemma Author report one such case, presenting with a clinical impression of ovarian malignancy, however, was diagnosed to be a case of extensive pelvic tuberculosis on laparoscopy. Tissue biopsy was consistent with the finding of tuberculosis.

Imaging description of extragenital müllerian adenosarcoma: A case report / Descrição da imagem do adenosarcoma mülleriano extragenital: relato de caso

Abstract Müllerian adenosarcoma is a very rare gynecological disease, comprising 5% of uterine sarcomas. Extragenital localizations are even rarer.We report a very interesting case of a 27-year-old woman complaining of pelvic pain, with a subsequent diagnosis of extragenital Müllerian adenosarcoma. This is the first case reported in the literature with a complete and wide imaging description. Even if rare, Müllerian adenosarcoma should be hypothesized in case of young female patients presenting with suspicious pelvic mass.

Resumo O adenosarcoma Mülleriano é uma doença ginecológica muito rara, compreendendo 5% dos sarcomas uterinos. Localizações extragenitais são ainda mais raras. Relatamos um caso muito interessante de uma mulher de 27 anos queixando-se de dor pélvica com diagnóstico subsequente de adenosarcoma Mülleriano extragenital. Este é o primeiro caso relatado na literatura com uma descrição completa e ampla de imagem. Mesmo que raro, o adenosarcoma Mülleriano deve ser hipotetizado no caso de pacientes jovens do sexo feminino com massa pélvica suspeita.

Reflections on Relationship Between Pathogenesis of Endometriosis and Intestinal Flora / 中国实验方剂学杂志

Endometriosis is a multiple disease that afflicts the health of women at childbearing age,and its incidence rate has been increasing year by year,furthermore,there has been a trend to be younger.At present,the pathogenesis of endometriosis has been not expounded completely,its cure rate is not high with high recurrence rate.In recent years,studies have shown that the human is a commensal body composed of a large number of microorganisms,and especially the microorganisms in the intestinal are closely related to the health of the body.Based on the previous studies on endometriosis,this paper proposes that its pathogenesis may be related to intestinal microbiological disorder,and aims to provide new ideas for the treatment of endometriosis.

Rapidly growing abdominopelvic mass - to be or not to be, not all we see is what it seems

The finding of a pelvic mass is often a source of great concern to our patients. Establishing the correct diagnosis and accurately staging these tumors is mandatory, but sometimes difficult, as abdominal masses may prove to be benign or malignant and have different etiologies. We describe a patient with a rapidly growing abdominal mass with weight loss and other accompanying symptoms, that together with the exams performed, posed a genuine diagnostic challenge to the team. Only after surgery the authors reached the definitive diagnosis of leiomyoma. Still waters run deep.(AU)

O achado de uma massa pélvica constitui frequentemente uma preocupação para as nossas pacientes. Estabelecer o correto diagnóstico e o estadiamento destes tumores com precisão é mandatório, mas por vezes difícil, uma vez que as massas abdominais podem ser benignas ou malignas e ter diferentes etiologias. Apresentamos um caso de crescimento rápido de um tumor abdominal associado a perda de peso e outros sintomas, que em conjunto com os exames realizados colocaram um desafio à equipe. Somente após a cirurgia os autores confirmaram o diagnóstico definitivo de leiomioma. As aparências iludem. (AU)

A Prospective Study on Reliability of Ultrasonography in Diagnosis of Gynaecologic Pelvic Mass in Tertiary Care Centre

Background: Ultrasound is utilized to outline the size, consistency and structure of starting point of pelvic mass. The analysis of pelvic mass can be surmised in light of proper history and corroborative sonographic findings. Ultrasound gives information about function and morphology of abnormal organ when pelvic examination is difficult. Methods: This prospective study was conducted on 43 patients visiting the Gynaecology department to evaluate the diagnostic reliability of ultrasonography in various gynaecologic pelvic masses. Out of 43 patients, only 32 patients with a variety of gynaecologic pelvic masses completed the study during the 6-month period in Himalayan Institute of Medical Sciences, Dehradun. Results: 32 patients with a variety of gynaecologic pelvic masses were evaluated, in 18 patients the Sonographic diagnosis was thought to be confirmatory of Clinical disease and in 11 patients, it revealed the actual status of 'patients. In 3 patients, the diagnosis was characterized as misleading. Conclusion: Ultrasound is useful in defining symptomatic or palpable pelvis mass as showed above.

Clinical characteristics and risk factors of pelvic mass in women after hysterectomy for benign disease / 中华妇产科杂志

Objective To explore how to reduce the incidence of pelvic mass after hysterectomy,and to evaluate clinical characteristics and the risks.Methods A retrospective study was carried out in 85 patients who returned for surgery due to a pelvic mass after prior hysterectomy for benign disease at Peking Union Medical College Hospital from January 2011 to June 2016.Results The majority of pelvic masses arising after hysterectomy and requiring surgery were benign (74％,63/85),while 19％ (16/85) were malignant and 7％ (6/85) were borderline.The most common type was ovarian endometrioma (24％,20/85) which usually occurs within the 5 years (16 cases),however,ovarian tumors (18 cases) were more likely to occur ≥10 years after hysterectomy.Characteristics associated with significantly increased likelihood of ovarian endometrioma were mainly ascribed to younger age [(47±5) years old],prior presence of endometriosis or adenomyosis (65％,13/20) and shorter time to pelvic mass onset [(3 ±3) years],as opposed to ovarian tumors (all P＜0.01).Additionally,higher number of prior abdominal surgeries significantly intensified the risk (RR=9.410,95％ CI:1.099-80.564,P=0.041).Conclusions The occurrence of pelvic mass after hysterectomy is tightly related to prior histologic findings,and particularly for ovarian endometrioma.Higher number of prior abdominal surgery will exacerbated the risk.It is effective to prevent the pelvic mass in women after hysterectomy if treat patients for the purpose of the risk factors.

Pelvic Intravenous Leiomyomatosis - Case Report / Leiomiomatose intravenosa pélvica - caso clínico

Abstract Introduction Intravenous leiomyomatosis is a benign and rare condition that can result in cardiac events with fatal outcomes when left untreated. Intravenous leiomyomatosis is probably underestimated because the diagnosis is easily missed. We present a case of an intravenous leiomyomatosis without extra-pelvic involvement, with a brief review of this pathology. Case Report 46-year-old woman submitted to hysterectomy and bilateral adnexectomy because of a pelvic mass detected in ultrasound. During the surgery, intravenous leiomyomatosis diagnosis was suspected. Pathological analysis confirmed this suspicion. Further imaging exams were performed without detecting any anomalies related to this condition. The patient remained with no evidence of disease after one year of follow-up. Conclusion Intravenous leiomyomatosis is a rare condition that can lead to serious complications. Early diagnosis followed by an appropriate treatment is very important to patient outcome, and underdiagnoses can be counteracted if the gynecologist is aware of this entity.

Resumo Introdução A leiomiomatose intravenosa é uma condição benigna, rara, que pode resultar em eventos cardíacos, podendo ser fatal quando não tratada. Esta patologia está provavelmente subestimada, uma vez que facilmente não é diagnosticada. Neste artigo, apresentamos um caso de leiomiomatose intravenosa sem envolvimento extrapélvico, com uma breve revisão da patologia. Relato de Caso Mulher de 46 anos de idade, submetida a histerectomia e anexectomia bilateral após detecção ecográfica de massa pélvica. Durante a cirurgia, houve a suspeita de leiomiomatose intravenosa, e o exame anátomo-patológico confirmou o diagnóstico. A paciente foi submetida a outros exames de imagem, não sendo detectada qualquer anomalia relacionada com a patologia. Após um ano de followup, a paciente manteve-se sem evidência de doença. Conclusão A leiomiomatose intravenosa é uma condição rara que pode levar a complicações graves. O diagnóstico precoce e o tratamento adequado são muito importantes para o prognóstico da paciente, e os subdiagnósticos podem ser evitados se o ginecologista estiver ciente dessa entidade.

Significance of serum human HE4 and CA 125 for diagnosis of epithelial ovarian cancer / 国际检验医学杂志

Objective To evaluate the value of HE4 ,CA125 in the diagnosis of epithelial ovarian cancer (EOC) .Methods A to‐tal of 54 samples with epithelial ovarian cancer ,64 suspicious benign pelvic mass ,and 60 health controls were consecutively enrolled in this study .Results Good diagnostic performance in discriminating benign from EOC patients was obtained for CA125 and HE4 . Serum level of HE4 of the patients in the three group were 189 .94 pmol/L ,56 .74 pmol/L and 46 .36 pmol/L .Levels of CA125 were 89 .39 U/L ,45 .11 U/L and 34 .24 U/L .There were stastically significant differences between the groups(P<0 .05) .The ser‐um HE4 and CA125 levels of the patients with ovarian cancer at stage Ⅲ ,Ⅳ(HE4=236 .25 pmol/L ,CA125=206 .35 U/L) were significantly higher than the cases at stage Ⅰ ,Ⅱ(HE4=96 .36 pmol/L ,CA125=67 .8 U/L P<0 .05) .Benign pelvic mass as con‐trol ,the specificity (SP) was 86 .6% ,sensitivity (SN) was 82 .6% ,positive predictive value and negative predictive value of the ser‐um HE4 were 85 .71% ,71 .67% ,73 .84% ,and 84 .31% respectively .SN of CA125 was 86 .67% ,higher than that of HE4 (71 .67% ,P<0 .01) .The area under curves (AUC) of HE4 was 0 .87 higher than that of CA125 (0 .81) ,(P<0 .01) .Combing de‐tection of ovarian cancer was higher than that of HE4 and CA125 alone .SP was 95 .15% ,negative predictive value was 92 .13%(P<0 .01) .Conclusion Overall ,the level of serum CA125 and HE4 increase significantly ,which showes well diagnostic perform‐ance to EOC from benign diseases .The combined detection of CA125 and HE4 could improve the diagnostic power in cervical cancer prominently ,so it has great reference value in the diagnosis of epithelial ovarian cancer .

Unilateral ovarian fibrothecoma with menorrhagia

Ovarian fibrothecoma is a relatively new term that is used to describe an ovarian sex cord stromal tumour that has mixed features of both fibroma and thecoma. The prevalence of ovarian fibrothecoma tumours is very rare and is reported to be about 1.2% of all ovarian tumours. We report a case of a 32-year-old woman who presented with acute menorrhagia with no previous medical, surgical or gynecological history. She was amenorrhic for four years after the insertion of a levonorgestrelreleasing intrauterine system (LNG-IUS) for contraception. The efficacy and location of LNG-IUS was reflected due to the sudden onset of menorrhagia. On pelvic examination and ultrasound the LNG-IUS could not be visualized and a uterine fibroid was noted. A diagnostic laparoscopy was done to identify the LNG-IUS, which revealed an incidental large ovarian mass on the left ovary. CA-125 level was elevated to 45 kU/L (Normal range <35 kU/L). Total abdominal hysterectomy, left salpingo-oopherectomy and cystectomy were performed. On histopathology, the mass was proven to be an ovarian fibrothecoma. No signs of malignancy were noted on peritoneal fluid cytology. The LNG-IUS was found inside the uterus. Our case is reported on the basis of the rare incidence of ovarian fibrothecoma and the possible effect it may have on the efficacy of LNG-IUS causing menorrhagia.

A Case of IgG4-Related Pancreas and Kidney Disease Mimicking a Renal Pelvic Malignancy / 대한내과학회지

IgG4-related sclerosing disease is a disease entity that has recently attracted attention, manifesting as a multiorgan disease characterized by high serum IgG4 levels, extensive IgG4-positive plasma cells and lymphocyte infiltration of the affected organs, with the pancreas (autoimmune pancreatitis) and kidney as representative targets. In cases of renal involvement, parenchymal lesions are predominant, such as renal cortical lesions or diffuse renal enlargement. However, mass-like lesions involving the renal pelvis are very rare, and mass forming or pelvic involvement types should be distinguished from lymphomas, metastatic cancers and other genitourinary malignancies to avoid unnecessary surgery. Herein, we report a case of IgG4-related sclerosing disease involving the kidney as an unusual involvement pattern presenting as a mass-like lesion with pelvic and perirenal involvement.

Discrimination between Benign and Malignant Pelvic Masses Using the Risk of Malignancy Index 1 / 대한폐경학회지

OBJECTIVES: To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses. METHODS: Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1. RESULTS: The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cut-off of 150 - with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4% - showed the highest performance in determining the malignant tendency of pelvic masses. CONCLUSION: Accepting a RMI 1 cut-off value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses.

Comparison of four malignancy risk indices in the detection of malignant ovarian masses / 부인종양

OBJECTIVE: The aim of this study was to evaluate the ability of four risk of malignancy indices (RMI) to detect malignant ovarian tumors. METHODS: This is a prospective study of 100 women admitted to the Department of Obstetrics and Gynecology of Gulhane Military Medicine Academy for surgical exploration of pelvic masses. To diagnose malignant ovarian tumors, the sensitivity, specificity, negative and positive predictive values and diagnostic accuracy of four RMIs (RMI 1, RMI 2, RMI 3, and RMI 4) were obtained. RESULTS: In our study we found that there is no statistically significant difference in the performance of four different RMIs in discriminating malignancy. We think that malignancy risk indices is more reliable than the menopausal status, serum CA-125 levels, ultrasound features and tumor size separately in detecting malignancy. CONCLUSION: We concluded that any of the four malignancy risk indices described can be used for selection of cases for optimal therapy. These methods are simple techniques that can be used even in less-specialized gynecology clinics to facilitate the selection of cases for referral to an oncological unit.

Causes and management for pelvic mass in adolescents / 中国综合临床

Objective To explore the clinical characteristics,causes,diagnosis and treatment of pelvic mass in adolescents caused by gynecologic diseases. Methods One hundred and twenty-six adolescents with gynecologic diseases presented as pelvic mass were retrospectively reviewed. Results The average age of all patients was 17. 6 years,ranging from 10. 0 to 19. 0 years. Ectopic pregnancy was found in 38 patients(30. 2%) ,the average age of the patients was 18.6 ±0.5 years, ranging from 17.0 to 19.0 years. Ovarian neoplasm was found in 35 patients (27. 8%) ,the average age of the patients was 17. 1 ± 2. 1 years, ranging from 10. 0 to 19. 0 years. Twenty cases (57. l%)had germ cell tumor, eighteen with mature teratomas, one with endodermal sinus tumor and one with immature teratoma. Thirteen cases(37. 2%)had epithelial ovarian tumors;eight with serous cystadenomas,three with mucinous cystadenoma, one with mucinous cystadenoma complicated with serous cystadenoma and one with borderline mucinous cystadenoma. Two cases had simple cyst of the ovary (5. 7%) . Congenital abnormality of reproductive tract was found in 14 patients (11. 1%), the average age was 14. 7 ±2. 2 years, ranging from 13.0 to 19. 0 years. Seven had imperforate hymens, two had rudimentary horn of uterus,four had atresia of vagina,one had atresia of vagina complicated with rudimentary horn of uterus,and one had oblique septum of vagina. Corpus luteum rupture was found in 11 patients (8. 7%) , the average age was 18. 1 ± 1. 9 years, ranging from 13. 0 to 19. 0 years. 116 patients underwent operative treatment and 10 patients underwent conservative therapy. Conclusions According to the stage of adolescents, main causes of pelvic mass in adolescents are different Main causes of pelvic mass in early adolescents are tumorous disease. Congenital abnormalities of reproductive tract are usually in middle adolescents. The gonads develop closely mature in late adolescent period; main causes of pelvic mass are ectopic pregnancy, ovarian neoplasm and physiologic ovarian cyst Surgery is the main therapy of pelvic mass in adolescents.

Krukenberg tumor in a teenager mimicking advanced ovarian cancer: Case report / 대한산부인과학회지

We experienced a case of Krukenberg tumor arising from transverse colon in a teenager who complained acute abdominal pain, which was confirmed by postoperative pathologic study and initially misdiagnosed as ovarian cancer with a huge pelvic mass, and report with a brief review of literatures.

Pelvic mass caused by gossypiboma / 대한산부인과학회지

Gossypiboma is referred to as surgical gauze or sponge left in the body of a patient inadvertently following surgery. There are two types of foreign body reaction in the body. The first type is exudative, with the resultant formation of an abscess with or without bacterial invasion and usually causes related clinical symptoms shortly after surgery. The second type is aseptic with extensive adhesions and encapsulating in a foreign body granuloma. Gossypiboma typically have an inconsistent radiologic appearance determined by the time, the type of material and the anatomical location. Furthermore, radio-opque markers are sometimes disintegrated or fragmented over times and ultrasound or CT may be indistinguishable from intra-abdominal abscess or tumor. We report 71-year-old woman in whom gossypiboma is severely adherent with ileal loop caused by pelvic mass.