Thyroid gland cutaneous fistula secondary to a migratory fish bone: a case report

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.