Migration of ingested foreign bodies into the thyroid gland: literature review and case report

Abstract

Objectives: We review the literature on the migration of ingested foreign bodies into the thyroid gland to analyze trends in patient presentation, evaluation, and management. Additionally, we present a case of an intrathyroidal foreign body from our own experience.

Methods: We searched the Medline database using key words "foreign bodies" and "thyroid gland," and present a new case report of an ingested foreign body that migrated to the thyroid gland.

Results: Our search generated 11 relevant articles with 15 total patients. All patients were female; 10 foreign bodies were fish bones, 2 were chicken bones, and 3 were wire bristles. The most common presenting symptoms were throat pain (67%) and dysphagia (47%). Computed tomography was the most sensitive test (100%), although cervical radiography also had high sensitivity (79%). Endoscopy was substantially less sensitive (38%). All patients required neck exploration.

Conclusions: Radiographic evaluation has a high likelihood of detecting foreign bodies in the thyroid gland, and a computed tomographic scan is doubly useful because it assists in preoperative planning. Endoscopy has limited utility in cases of extraluminal migration, but should still be performed to evaluate soft tissue that is poorly visualized on a computed tomographic scan. Unless the foreign body can be removed endoscopically and there are no complications from migration or perforation, the definitive treatment is surgical.