Textiloma of the frontal bone twenty years after craniotomy for Apert syndrome

Introduction The presence of intracranial foreign body granulomas is an unusual condition. They can be caused by foreign substances which are either inadvertently or deliberately left in the surgical field. Some foreign materials (textilomas, gossypibomas, gauzomas, muslinomas) along with the resulting foreign body reaction, in the surrounding tissue, can cause infection or abscess formation in an early stage whereas others remain clinically silent for many years. Patient We present the case of a foreign body granuloma (textiloma) caused by a gauze which had been placed, during a corrective craniotomy, in a patient with Apert syndrome at the age of five. At presentation the clinical and radiological findings were suggestive of an infection. Results Surgical exploration of the region demonstrated the presence of gauze, in a frontal bone defect, surrounded by large masses of reactive granular tissue which were extended to the underlying dura mater. The symptoms resolved completely after the foreign body’s retrieval. Conclusion Foreign body granulomas, although rare, must always be taken under consideration in the differential diagnosis of craniofacial masses or procedures; especially in cases where a previous craniofacial operation has taken place.