We describe the rare case of a 71-year-old man with a chest mass that was found to be an intrathoracic gossypiboma left 52 years earlier during an emergency lung bilobectomy. This mass was complicated by extension across the chest wall. There are no reports in the literature of a patient carrying a thoracic gossypiboma for such a long period of time, let alone with extension across the chest wall.

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HighlightsThis case report represents one of the youngest patients ever presented with this condition without any risk factors, and her follow up for three years.Multiple adenocarcinomas of the small bowel is an extremely rare disease with no standardized treatment.Its clinical presentation can vary from abdominal pain, mass, obstruction and bleeding, requiring a high index of suspicion.Its treatment is predominantly surgical and adjuvant therapies are now being studied in randomized controlled studies.

Patient: Male, 51-year-old Final Diagnosis: Adeno virus liver failure Symptoms: Liver failure Medication: — Clinical Procedure: — Specialty: Transplantology Objective: Unusual clinical course Background: Human adenovirus is a well-known pathogen that can potentially lead to severe infection in immunocompromised patients. Adenovirus infections in solid-organ transplant recipients can range from asymptomatic to severe, prolonged, disseminated disease, and have a significant impact on morbidity, mortality, and graft survival. The clinical manifestations vary from asymptomatic and flu-like illness to severe life-threatening viremia with multi-organ failure. Post-transplant adenovirus infection is well described in kidney recipients, but in adult liver transplant recipients the impact of the virus is not well described. In this report, a case of disseminated adenovirus infection with subsequent fatal acute liver failure in a post-kidney transplant patient is presented. Case Report: A 51-year-old man underwent a deceased kidney transplantation for focal segmental glomerulosclerosis. Shortly after the kidney transplantation, he received multiple plasmapheresis with additional steroid treatments for cellular rejection and reoccurrence of his primary kidney disease. Three weeks after the kidney transplant, he developed a disseminated adenovirus infection with subsequent acute liver failure. Despite the early diagnosis and aggressive treatment, the patient died. Conclusions: Patients with organ transplantation with autoimmune background etiology are usually over-immunosuppressed to avoid early rejection. In this population, opportunistic infections are not rare. Fever, general malaise, and transplant organ dysfunction are the first signs of bacterial or viral infection. Early infectious diseases work-up, including tissue biopsy, is fundamental to establish a diagnosis. Broad antibiotic and possible antiviral aggressive treatment are mandatory.