Misdiagnosis of gossypiboma as hydatid cyst.

A 51-year-old woman was admitted for diabetes control. She was found to have a firm, mobile, large epigastric mass during physical examination. Laboratory findings were within normal range. She had undergone cholecystectomy at another hospital 8 years ago. On computerized tomography (CT) of abdomen showed a large intra-abdominal cystic mass measuring 102 cm× 106 cm×181 cm, originating from duodenopyloric junction, which compressed duodenum and pylorus. The appearance of the mass was consistent with type II hydatid cyst (Fig. 1). The patient was advised albendazole therapy; 2 months later, the cyst was treated by puncture, aspiration, injection of a helminthicide, and reaspiration (PAIR) technique. Analysis of cystic fluid was not consistent with hydatid cyst. A post-treatment CT scan showed a reduced size of the cyst; however it returned to its original size within 3 months after treatment. The patient underwent a diagnostic laparotomy which detected four sponges within the cyst (Fig. 2).