Presentation
Had subtotal thyroidectomy for resistant Graves disease 3 months prior. Presented with painful swelling of the right cervical region with fever.
Patient Data
Well-defined right cervical hyperdense ovoid structure with no enhancement at the thyroidectomy bed, lateral to the thyroid cartilage, anterior to the internal jugular vein and CCA and medial to the sternocleidomastoid muscle. Surrounding inflammatory changes as well as cutaneous thickening with densification of the adjacent subcutaneous fatty tissue. An adjacent fistulous tract is noted extending from the ovoid structure and reaching the skin. Ipsilateral reactive cervical lymphadenopathy is noted.
Small remnant tissue of the left thyroid lobe.
The ultrasound exam revealed an arciform echogenic structure with intense posterior acoustic shadowing located in the right cervical region with an adjacent hypoechoic collection as well as reactive lymphadenopathy.
Case Discussion
CT and ultrasound features of an infected gossypiboma with a fistulous tract that was confirmed at surgery.
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