Gossypiboma - neck

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

The patient presents with a right-sided neck mass post-total thyroidectomy.

Patient Data

Age: 20 years
Gender: Female
ultrasound

The left thyroid bed appears clear in a setting of total thyroidectomy secondary to thyroid carcinoma.
Within the right thyroid bed, there is an echogenic mass measuring 3.37 x 1.23 x 3.73 cm with posterior acoustic shadowing.
There are no suspicious lymph nodes, no necrotic lymph nodes and no nodal abscesses.
The cervical soft tissues are otherwise normal post-surgery.

ultrasound

The video clip demonstrates an echogenic, circumscribed mass, inferior to the right sternocleidomastoid muscle with associated posterior acoustic shadowing.

x-ray

The cervical views confirm the paramidline surgical clips consistent with a history of total thyroidectomy. The serpiginous, linear, radiopaque strips of the retained surgical sponge or gauze are well-identified within the right thyroid bed. There are no associated gaseous locules.

There is a reversal of the normal cervical lordosis suggesting severe pain and or muscle spasm.

Case Discussion

Features consistent with a retained surgical swab/ gauze within the cervical soft tissues post-total thyroidectomy. The patient was non-septic and had an unremarkable recovery post-surgical removal of the retained foreign body.

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