Spanish surgeons who thought they were removing a tumor from a man's face discovered that the problem was actually a fragment of a ballpoint pen undetected for 22 years.

According to the report in the June issue of the Journal of Oral and Maxillofacial Surgery, the 26-year-old patient had sought medical help for a swelling on the side of his face, near his right ear. He said it had appeared two years earlier and had grown steadily.

After X-rays showed an abnormality in a salivary gland, doctors assumed it was a benign tumor and scheduled surgery to remove it. But the operation uncovered an inch-long fragment of a ballpoint pen, and no evidence of tumor. The patient had a normal recovery and left the hospital two days later.

"After direct questioning, the patient's parents recalled a fight with his brother when he was 4 years old, during which he was punctured inside the mouth with a pen" that 22 years later was finally removed, doctors reported.

Foreign bodies are only rarely discovered in salivary glands, but other doctors have reported finding toothpicks, blades of grass, a toothbrush bristle, hair, a chicken feather and the tip of a pool cue, according to the physicians in Barcelona who wrote the report.