We report on a 71-year-old female patient who presented with a progressive, piercing
foreign body sensation a few hours after fish consumption in November 2020. After
a clinically unremarkable ENT examination, endoscopy was performed under general anesthesia.
Here, no foreign body could be detected either. However, a small patch of granulation
tissue was noted on the anterior wall of the right piriform sinus. Histopathological
examination of a biopsy taken here revealed only reactive epithelial changes. The
patient could be discharged from the inpatient stay with already regressive symptoms.
5 days later, the patient was presented again from a peripheral hospital with fever,
general fatigue, and progressive odynophagia. Examination continued to show no foreign
body and only a minor case of cervical lymphadenopathy. The patient was admitted to
the hospital for i.v.-antibiotic therapy. Due to the lack of improvement and clinical
hints on a thyroiditis, the patient received several radiological examinations and
was presented for a nuclear medicine co-evaluation. The combined findings of sonography,
CT-scan and a MRI led to the suspicion of a foreign body in the right lobe of the
thyroid gland, presumably the fish bone beeing the cause of the inflammation. After
failed attempts at ultrasound-guided or endoscopic removal of the fishbone, the patient
finally received a hemithyroidectomy. Intraoperatively, the fishbone could be salvaged.
The patient recovered completely.
