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November 1986

A Half Shell of a Pistachio Nut That Simulated a Tumor

Author Affiliations

Department of Pediatrics Cooper Hospital/University Medical Center University of Medicine and Dentistry of New Jersey–Rutgers Medical School at Camden 1 Cooper Plaza Camden, NJ 08103

Am J Dis Child. 1986;140(11):1100. doi:10.1001/archpedi.1986.02140250026024

Sir.—We herein present a patient report of an unusual ingestion.

Patient Report.—A mass was noted on the hard palate of a 6-month-old infant. Physical examination revealed a fleshy-colored, rock-hard mass firmly attached in the midline on the hard palate (Fig 1). Results of the physical examination were otherwise normal. The differential diagnosis included a hemangioma, lymphangioma, sarcoma, metastatic tumor, and an encephalocele. Undaunted by this diagnostic dilemma, the resident, who was intellectually challenged, vigorously jiggled the mass and dislodged it (Fig 2). She was stunned when she realized that it was a half shell of a pistachio nut. The rim was essentially in one plane. The usual red color was absent except along the rim.

I experimented with a half shell of a pistachio nut and discovered that one can easily produce a vacuum to force adherence to the hard palate, and the color on the shell will

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