Clin Exp Otorhinolaryngol.  2013 Dec;6(4):269-271.

Gossypiboma of the Neck Mimicking an Isolated Neck Recurrence

• Kim KJ
• Lim JY
• Choi JS
• Kim YM

Abstract

A gossypiboma (also called textiloma or retained surgical sponge) of the neck is rarely reported compared to intraabdominal or intrathoracic gossypibomas and also can be misdiagnosed as metastatic lymph nodes. A patient was referred to our clinic for a supraclavicular neck mass 6 months after thyroidectomy and neck dissection for papillary thyroid carcinoma in another hospital. It was initially considered an isolated neck recurrence, but it was finally diagnosed as gossypiboma by a pathological examination of the surgically-excised specimen. Characteristic findings of computed tomography or positron emission tomography/computed tomography might be helpful to differentiate the gossypiboma from malignant neck mass or other inflammatory conditions. It is essential for clinicians to be aware of this disease entity in differential diagnosis of neck recurrence because a gossypiboma in the neck can be misinterpreted as a malignancy to induce unwarranted radical surgery.

Keyword

Gossypiboma; Surgical sponge; Neck surgery

MeSH Terms

Carcinoma
Diagnosis, Differential
Electrons
Humans
Lymph Nodes
Neck Dissection
Neck*
Recurrence*
Surgical Sponges
Thyroid Neoplasms
Thyroidectomy

Figure

• 

  Fig. 1 The radiologic findings of retained gauze. (A) Neck computed tomography (CT) shows a low attenuating homogenous central mass with a hyperdense, well-enhancing, irregular rim. (B) Positron emission tomography/CT depicts the hot uptake on the rim of the left supraclavicular mass and no uptake on internal area of mass.

• 

  Fig. 2 (A) Cross section view. The specimen shows retained gauze with external capsule formation. (B) Microscopic examination revealed a foreign body with dense fibrocystic wall with a lining of multinucleated giant cells. Chronic inflammatory cell infiltrations were also visible around the foreign body (H&E, ×100).

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