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A woman in her late 80s presented for the exchange of a percutaneous endoscopic gastrostomy (PEG) button (Ideal Button, Olympus; 24 Fr, 3.5 cm). The device had been placed approximately 2.5 years (900 days) earlier at a tertiary university hospital for nutritional support during treatment for Stage IVA right oropharyngeal cancer (squamous cell carcinoma, p16-negative). Although she was subsequently followed at a regional hospital, the PEG remained unused and unmanaged as she maintained oral intake. The lack of routine maintenance was identified only when she visited our general medicine clinic on a remote island. Although asymptomatic regarding abdominal pain, the patient requested removal due to a persistent foul odour from the stoma site and psychological anxiety about the long-term retained foreign body.