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Removal of foreign bodies from the upper gastrointestinal tract, though a common occurrence, can be technically challenging and risky. We report the case of a young man that, after eating a pizza cooked in a wood-burning oven, reported a sense of foreign body. Though the first evaluation by fiberoptic laryngoscopy found no foreign body, after a few weeks, the patient was readmitted from the ER for worsening symptoms and fever. A CT scan showed a metallic mediastinal foreign body inside a large fluid collection. After multidisciplinary evaluation, an endoscopic removal was attempted by accessing the mediastinal collection through EUS-guided positioning of a Hot Axios™ stent. The cavity was drained by naso-esophageal suction. The foreign body was a fragment of the brush used to clean the oven. The patient is now doing well after 7 months. [ABSTRACT FROM AUTHOR]