Case Report | Open Access
Volume 2023 - 2 | Article ID 237 | http://dx.doi.org/10.51521/WJCRCI.2023-22-210
Academic Editor: John Bose
Emira Hysa.MD* Eugerta Dilka PhD**.
Olvis Petre PhD*, Franc Rrumbullaku MD*, Prof.Perlat Kapisyzi FCCP**
*University
Hospital “Shefqet Ndroqi’’ Tirana Albania
**University of Medicine Tirana Albania
Corresponding Author: Prof.Perlat Kapisyzi FCCP, University of Medicine Tirana Albania.
Citation: Emira Hysa, Eugerta Dilka, Olvis Petre,
Franc Rrumbullaku, Prof. Perlat Kapisyzi (2023). Intrathoracic Challenging Mass
Ultrasonographic Video Presentation. World J Case Rep Clin Imag. 2023 November;
2(2)1-4.
Copyrights © 2023, Perlat Kapisyzi, et al. This article
is licensed under the Creative Commons
Attribution-Non-Commercial-4.0-International-License-(CCBY-NC)
(https://worldjournalofcasereports.org/blogpage/copyright-policy). Usage and
distribution for commercial purposes require written permission.
ABSTRACT
Background: The diagnostic value of lung ultrasound in
identifying intra-thoracic masses following previous surgical interventions is
shrouded in intrigue. Under-reporting and medico-legal concerns further
complicate the identification and diagnosis of such cases. This study aims to
unravel the enigmatic ultrasound characteristics of a unique intra-thoracic
mass, accompanied by an enthralling ultrasound video presentation.
Case
Report: In this
captivating case, a 66-year-old patient, who had undergone aortic valve
replacement surgery five years prior, presented for a routine check-up. An
incidental hypo echoic image in the lung sparked further investigation. Imaging
studies revealed a distinct round mass, and lung ultrasound provided intriguing
insights into its features, including hypo echoic, hyper echoic density,
posterior hyper echoic densities, and dynamic changes with probe manipulation.
Surgical intervention uncovered a suppurated cystic formation and a retained
surgical material from the previous procedure.
Conclusion: The unconventional nature of an
intra-thoracic round mass following prior surgical intervention adds an aura of
mystique to this case. Diagnosis and management are complex due to limited
reported cases and medico-legal considerations. By sharing the captivating
ultrasound characteristics and video presentation of this unique case, we aim
to deepen our understanding of this enigmatic phenomenon and raise awareness
among clinicians. This knowledge can aid in the timely identification and
appropriate management of similar cases, ultimately improving patient outcomes.
The diagnostic value of lung ultrasound in intra-thoracic masses should not be
overlooked, offering a radiation-free approach to post-operative follow-up and
the detection of late complications.
KEYWORDS: Thoracic ultrasound, Intrathoracic mass, Gossypiboma
VIDEO PRESENTATION
1. Sozutek A,
Karabuga T, Bozdag AD, et al. Asymptomatic gossypiboma mimicking a liver mass.
Turk J Surg. 2010; 26:225–228.
2. Koul P,
Mufti S, Khan U, Jan R. Intrathoracic gossypiboma causing intractable cough.
Interact Cardiovasc Thorac Surg. 2012;14(2):228–30.
3. Seema
Chopra, Vanita Suri, Pooja Sikka, Neelam Aggarwal: A Case Series on Gossypiboma
- Varied Clinical Presentations and Their Management. J Clin Diagn Res. 2015
Dec;9(12)
4. Zantvoord Y,
van der Weiden RM, van Hooff MH. Transmural migration of retained surgical
sponges: a systematic review. Obstet Gynecol Surv. 2008;63:465–471.
5. Sharifah A Othman
et al. Intrathoracic Gossypiboma: An Overlooked Entity Am J Case Rep. 2020.
6. Parra M,
Oppliger F, Berríos R, Schiappacasse G. Intrathoracic gossypiboma presenting 52
years later as a chest mass. Asian Cardiovasc Thorac Ann. 2014;23(5):596–98
7. Chau WK, Lai
KH, Lo KJ. Sonographic findings of intra-abdominal foreign bodies due to
retained gauze. Gastrointestinal Radiol 1984; 9(1):61-63.
8. Shyung LR,
Chang WH, Lin SC, et al. Report of gossypiboma from the standpoint in medicine
and law. World J Gastroenterol 2005; 11:1248 –1249.
9. Gulsen A.
Intrathoracic gossypiboma: 2 case reports and review of the literature. JLPRR.
2016;3:100.
10. M Coşkun et
al.CT features of pericardial gossypidoma. Eur Radiolog.199;9(4):728-730
11. T
Suwatanapongched, et al. Intrathoracic gossypiboma: radiographic and CT
findings. Br J Radiol. 2005.;78(933):851-853.
12. César
García de Llanos, et al. Intrathoracic gossypiboma interpreted as bronchogenic
carcinoma. Another false positive with positron emission tomography.Arch Bronconeumol.2007;43(5):292-294.
13. H J Park,SA
Im,HJ Chun.Changes in CT appearance of intrathoracic gossypiboma over 10 years
Br J Radiol. 2008;81:e61-e63.
14. Ruquaya
Mir, Singh VP.Retained intra- thoracic surgical pack mimicking as recurrent
aspergilloma. J Clin Diagn Res. 2012;6(10):1775-1777.
15. Carlos
Miguélez Vara, Marinan Gorospea M.Resected asymptomatic intrathoracic textiloma
37 years after thoracotomy. Arch Bronconeumol.2010.;46(9):492-493.