Thyroid Cutaneous Fistula Secondary to a Migratory Fish Bone

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Thyroid Cutaneous Fistula Secondary to a Migratory Fish Bone

Abstract and Introduction

Abstract


Introduction We report an extremely rare case of a migratory fish bone penetrating through the thyroid gland.
Case presentation A 56-year-old Japanese woman presented with a two-month history of a painless cutaneous fistula in her anterior neck with pus discharge. Endoscopic examinations showed no abnormality, but computed tomography revealed a bone-density needle-shaped foreign body sticking out anteroinferior from the esophagus wall, penetrating through her left thyroid lobe and extending nearly to the anterior cervical skin. A migratory fish bone was suspected, and the foreign body was removed under general anesthetic, combined with a hemithyroidectomy. The injured esophageal mucosa was sutured and closed. Our patient's postoperative course was uneventful, and she was allowed oral food intake seven days after the surgery. No evidence of recurrence was seen over the postoperative follow-up period of 42 weeks.
Conclusion We should be aware that fish bone foreign bodies may migrate out of the upper digestive tract and lodge in the thyroid gland.

Introduction


Fish bones are one of the commonest foreign bodies occurring in the pharynx or cervical esophagus. Fish bone foreign bodies located outside the aerodigestive tract are relatively rare. Here, we present an extremely rare case of a migratory fish bone penetrating through the thyroid gland with a cutaneous fistula in the anterior neck one year after swallowing the foreign body.

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