October 9, 2017

This man's supposed tumor turned out to be a toy he inhaled—40 years ago

Daily Briefing

    When a 47-year old man presented with a mass in his lungs, the doctors went in expecting cancer—but what they found was much more surprising (and nostalgic): The patient had a tiny Playmobil plastic traffic cone lodged in his airways, accidentally inhaled about 40 years prior, according to a case study in The BMJ.

    At first, doctors suspected cancer

    According to his physicians, the man, whose name was not released, was a long-time smoker and had been suffering from a bad cough for over a year. When doctors looked at X-rays of his lungs, they spotted a mass in his right lung that they thought could be cancer.

    But when the doctors performed a bronchoscopy, they didn't find a tumor at all. Instead, they discovered a "long-lost Playmobil traffic cone" that the man had received for his 7th birthday, 40 years ago. According to the case study, "Following the procedure, the patient reported that he regularly played with and even swallowed pieces of Playmobil during his childhood."

    A rare case

    The patient was diagnosed with tracheobronchial foreign body aspiration (TFB). But while TFB is fairly common among children, the doctors wrote that "a case in which the onset of symptoms occurs so long after initial aspiration is unheard of."  The doctors identified only three other instances of patients enduring TFB for more than 20 years—and they suspected that their case might mark the first instance of a patient presenting with the condition after more than 40 years.

    According to the doctors, the man likely didn't present any symptoms because he swallowed the toy at such a young age, and the lungs may have adapted to it. "For example, during childhood it may have been absorbed into the mucosal lining of the bronchus which developed around it," they wrote. Further, they pointed out that any symptoms linked to the toy might have previously been masked by the patient's tobacco use.

    The doctors said they successfully removed the small toy, measuring about 1 centimeter in length with biopsy forceps. While there is some permanent damage to his airway, the man's cough "almost entirely settled." And, of course, the patient "finally found his long-lost Playmobil traffic cone in the very last place he would look," the doctors concluded (Welch, CBS News, 9/27; Marshall, Yahoo News, 9/27; McDonald, KMOV, 9/27; Slawson, The Guardian, 9/26; BBC News, 9/26).

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