A stranger in the heart: Gossypiboma

Full text: A 61-year-old male presented with chest pain and shortness of breath. A chest radiograph showed a right paracardiac mass. Cardiac CT was performed. CT revealed a mass lesion adjacent to right atrium with smooth margins. Contrast-enhanced images showed curvilinear, high-density stripes similar to vascular structures. Since these linear hyperdensities were also observed pre-contrast images, we noticed these structures were not vessels. Cardiac MRI was applied to demonstrate relationship between the lesion and right atrium. MRI showed extracardiac mass lesion which compress right atrium and bilateral pleural effusion with compression atelectasis in lower lobe of right lung. There was not pericardial effusion. Patient described open cardiac surgery 10 years ago. He also remembered a febrile period after a short time cardiac surgery and couldn't be found any focus of fever. The patient underwent thoracotomy and resection of the right paracardiac mass. Histopathologic specimens reveal foreign body remains under polarized light, fibrosis and foreign body reaction. Consequently, the presence of a forgotten sponge should be kept in mind in patients who had intrathoracic mass lesion even after many years from surgery