# Perforation of the Large Intestine by a Fish Bone Mimicking Cancer: A Rare Case Report

## TL;DR

An elderly man's fish bone perforated his colon, mimicking cancer, highlighting the need to consider foreign objects in similar cases.

## Contribution

Highlights the rare but important differential diagnosis of fish bone perforation mimicking colonic cancer.

## Key findings

- A fish bone was found to cause sigmoid colon perforation in an elderly patient.
- Initial imaging failed to detect the foreign object, leading to a cancer suspicion.
- Surgical intervention confirmed the foreign body and resolved the issue without malignancy.

## Abstract

This case report details an 80-year-old male who presented with a 12-day history of progressive left lower quadrant abdominal pain. Imaging studies revealed a mass adjacent to the sigmoid colon with signs suggestive of an abscess, but no foreign body was identified preoperatively. Surgical exploration uncovered a sigmoid colon perforation associated with a sharp foreign object, later confirmed to be a fish bone. Histopathological examination demonstrated an inflammatory response without evidence of malignancy. The patient underwent a segmental colectomy with favorable postoperative recovery. This case underscores the diagnostic challenge of foreign body perforation of the colon, particularly when initial imaging fails to identify the foreign object. It highlights the importance of considering ingested fish bones in the differential diagnosis of colonic perforation in elderly patients, especially those with risk factors such as denture use. The report emphasizes the role of surgical intervention in the diagnosis and management of such rare cases, which can mimic neoplastic processes.