Intrathoracic migration of a screw in the cervical spine: a case report

Kalaycioglu S., FINDIK G., Aydogdu K., Dagli G., Kaya S.

TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, cilt.18, sa.4, ss.338-340, 2010 (SCI-Expanded, Scopus, TRDizin)

Özet

Intrathoracic foreign bodies are frequently seen after aspiration of particles or penetrating chest injury. The clinical presentation of intrathoracic foreign bodies includes acute airway obstruction and recurring infections. In a 56-years-old male patient, a screw which had been used for vertebral fixation of a cervical fracture five years ago could not be found in its location in the postoperative first year control chest X-ray and was found instead in soft tissues of the neck. Four years later, on regular control X-rays, the screw could not be found in the patient's neck and was seen in the thorax with a 6 cm diameter cavity lesion. When the patient was referred to our clinic, he had been complaining of continuous cough and fever for two months. A metallic foreign body image (the screw) in the left hilar region and a paravertebral cavitary lesion located between apex and hilum was observed on thoracic computed tomography. Because there is no anatomic connection between the cervical region and thorax, the migration of the screw to the thorax after four years of follow-up is an unexpected finding. The lesion was explored with thoracotomy for diagnosis and treatment. The screw was extracted and the cavity wall was dissected, then damaged lung tissue was removed by wedge resection.