Misdiagnosis of thyroid penetration caused by fishbone ingestion: a case report and literature review

Abstract

Background: Foreign body ingestion is a common occurrence. However, thyroid penetrating injury caused by fishbone migration is rare.Case Description: In this study, we present a rare misdiagnosed case of a fishbone fixed in the thyroid with a negative diagnosis on laryngoscopy examination. A 52-year-old woman experienced severe and persistent left anterior cervical pain when eating fish. Laryngoscopic imaging at an external hospital, revealed a cyst with a maximum length of 2 cm on the epiglottis, and epiglottic cyst resection under a laryngoscope was performed. The pain was not relieved, and the patient was referred to our hospital. Computed tomography and ultrasound examinations showed a sloping foreign body with a length of approximately 2.5 cm from top to bottom in the left lobe of the thyroid gland. The possibility of a penetrating fishbone injury was considered, and the foreign body was surgically removed. Postoperative drainage, fasting, and antibiotics were prescribed for 3 days, and then the patient was discharged. Follow-ups for 40 days suggested that she had recovered well without complications. Conclusions:The presence of a migratory fishbone should be considered when a patient has a history of fishbone ingestion but laryngoscopy or esophagoscopy assessment of foreign body ingestion is negative.

Persistent hypocalcemia post total thyroidectomy in a case of Hashimoto's thyroiditis

“…Managing the risk factors associated with hypocalcemia following thyroidectomy emphasize a comprehensive approach to identify and address the potential contributors. Key strategies include meticulous surgical techniques to minimize damage to the parathyroid glands, preserving the blood supply to these glands, and ensuring their intraoperative identification to prevent inadvertent removal [ 14 ].…”