At the Viewbox: Foreign Body Masquerading as a Lesion in the Mouth

Foreign Body Masquerading as a Lesion in the Mouth

A 7-year-old girl presented for a low dose noncontrast computed tomography (CT) of the paranasal sinuses for chronic cough. During immediate review of the images, there was a partially visualized ovoid, high attenuation, apparent mass in the left buccal soft tissues adjacent to the mandibular body (A). After discussion with the patient and parent, a repeat CT with intravenous contrast was recommended and obtained. The repeat scan failed to demonstrate a lesion at the region of interest (B). The technologist noted that the child had expelled an object from her mouth into the trash can between the 2 studies. Further discussions revealed that the patient had a cough drop in her mouth to prevent coughing during the initial scan and subsequently discarded it. The cough drop was retrieved, placed in a cup of water, and CT images were obtained, demonstrating a high-attenuating ovoid object, identical to the “mass” initially seen (C).

Foreign bodies may be encountered in the oral cavity in a variety of clinical scenarios (ingested, iatrogenic, etc.).¹ It is important to consider a foreign body in the mouth masquerading as a lesion, as comestible intraoral foreign bodies may be mistaken for pathology.²

References

1. Reginelli A, Santagata M, Urraro F, et al. Foreign bodies in the maxillofacial region: assessment with multidetector computed tomography. Semin Ultrasound CT MR 2015;36(1):2-7.
2. McDermott M, Branstetter BF, Escott EJ. What’s in your mouth? The CT appearance of comestible intraoral foreign bodies. Am J Neuroradiol 2008;29(8):1552-1555.