Textiloma is defined as a tumor composed of cotton matrix surrounded by granulomatous reaction. It occurs following operations in which surgical sponges were inadvertently left behind. We describe a case of a 59-year-old man presenting with a pathologic fracture of the proximal left femur. The results of the biopsy, unlike diagnoses suggested by radiographs, CT scan and magnetic resonance imaging revealed a textiloma of 23 years of evolution. Because of major bone loss, resection of the involved bone was performed followed by ipsilateral fibular bone graft.
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