Intrathoracic Gossypiboma: Diagnosed or Undiagnosed?
چکیده
Background: Intrathoracic Gossypiboma refers to a retained surgical sponge in the thoracic cavity. It is a rare entity which is capable of producing serious complications. Objective: The aim of this study was to review case reports in the English literature on diagnosed and undiagnosed intrathoracic gossypibomas to heighten the awareness of this entity and decrease the rate of future misdiagnosis. Method: In reviewing the literature, 37 cases were reported. The reports indicated cough, sputum expectoration, dyspnea, and chest pain as common symptoms. Hemoptysis was rarely reported with massive hemoptysis being reported in only two patients. Results: There were 17 patients who had cardiovascular surgery and 18 patients who had a thoracotomy, all found to have an intrathoracic gossypiboma. Two patients had a history of spinal operation, and abdominal cholecystectomy. Radiograph of the chest, MRI, and PET were not found to be useful as diagnostic tools. Chest tomography (CT) scan demonstrated heterogeneous, hypodense masses in all the patients scanned and due to difficult and confusing diagnosis of intrathoracic gossypibomas, 28 out of 37 (75.68%) patients remained undiagnosed. In our case, chest CT scan findings favored benign lesions, calcified granuloma, calcified carcinoid, and calcified hamartoma. Conclusion: An intrathoracic gossypiboma usually goes undiagnosed. Patients usually need surgery for removal of the retained sponge. Gossypibomas can cause medicolegal implications for surgeons and should be in the differential diagnosis in all patients with a lung mass and history of a thoracic surgery.