A Case of Fish Bone Foreign Body Presenting as Anterior Neck Mass

Ahn, Cheol Min; Choi, Ji Ho; Woo, Won Keun; Kim, Mi Ra

Abstract

Foreign bodies in the oral cavity and pharyngolarynx are commonly encountered accidental cases in the emergency room and out patient departments in the otolaryngological fields. Of such foreign bodies, fish bones are the most commonly observed. Most foreign bodies in oral cavity, laryngopharyngeal, and esophagus can be recognized and their precise locations can be plotted by careful history taking, precise physical examination, and through simple radiological procedures. Similarly, their removal is relatively simple with the manipulation of endoscopes and various instruments. Reports of such foreign bodies are relatively frequent in their finding, however, foreign bodies that penetrate the esophagus and laryngopharynx to appear as a cervical mass are rare. When such foreign bodies migrate, locating their precise positions must involve a more thorough search utilizing such aids as computed tomography. Similarly, their removal may involve surgical intervention depending upon their location. The authors of this study experienced such a rare case of an elderly female patient aged 62, presenting an anterior neck mass of 7 days as a chief complaint. She had swallowed a fish bone 10 days ago. Her standard battery of blood tests, simple cervical X-ray and endoscopic findings all proved within normal limits. However, an excisional biopsy of the involved site revealed a piece of fish bone that had penetrated the pharyngolarynx and had migrated to position itself as an anterior neck mass. We hereby report this case along with the relevant literature.