A curious case of a comestible cough candy

Abstract

An 80-year-old woman was seen in the Emergency Department with a history of left jaw pain and headaches, as well as numerous additional comorbidities. Computed tomography examination of the head and face found a circumscribed, ovoid, markedly hyperattenuating mass with areas of internal air within the left buccal space – the density of which was neither that of metal nor bone. After speaking with the patient, she reported having a cough candy in her mouth during the examination. Here we review the imaging appearance of an unusual case of a comestible intraoral foreign body so as to raise awareness of this incidental pseudolesion. Correct recognition of this as an intraoral foreign body rather than true pathology of the oral cavity is important as to save patients the anguish of a significant, albeit incorrect, diagnosis and avoid the additional cost and resource utilization of unnecessary further investigations.

The Importance of Imaging in the Detection of Intraoral Foreign Body

“…While it is common practice for patients to be asked to remove any foreign body from their oral cavity prior to imaging, occasionally, this may not happen, especially in emergency settings with a large number of patients and rapid clinical assessments. This potential pitfall can result in IOFB being reported as pathological lesions, such as traumatic foreign bodies, mucosal neoplasms, or soft tissue abscesses, by an unaware radiologist [ 1 , 2 ]. Current literature on the radiological findings of comestible IOFBs is relatively scarce.…”