Fillers Could Cause Foreign Body Granuloma Formation

Although a variety of injectable cosmetic fillers are in high demand, physicians should be aware that rare adverse reactions—like foreign body granulomas—are being reported, according to a case report.

Injectable permanent fillers containing polymethyl methacrylate (PMMA) immersed in a solution of collagen have been implicated in several types of adverse reactions, reported Dr. M.C. da Costa Miguel of the department of oral pathology at the Federal University of Rio Grande do Norte, Brazil, and his colleagues.

Foreign body granulomas only develop in some patients, and this particular granuloma formation caused by a reaction to injectable fillers is only observed in 0.01% of patients, further adding to the diagnostic challenge, the researchers wrote.

Dr. da Costa and his colleagues found the granulomas in a 56-year-old woman after performing a number of examinations. Initial examinations showed a "firm, pink nodule covered with non-ulcerated mucosa located in the right anterior inferior alveolar mucosa." The swelling was painless and moveable. There was no bone involvement, no palpable adenopathies, and the patient showed no symptoms of atopy (Int. J. Oral Maxillofac. Surg. 2009;38:385-7).

Salivary gland mucocoele was considered initiallly. After a biopsy, the researchers found that "immunohistochemical analysis using anti-CD68 antibody confirmed the presence of numerous macrophages and CD68-positive multinucleated giant cells."

The patient was asked if any aesthetic procedure had been performed close to the site of her swelling and she confirmed that she had an injection of a cosmetic filler containing PMMA for lip enlargement about 1 year earlier.

According to Dr. da Costa and his colleagues, what made this case particularly rare was its "unusual clinical presentation as a painless nodule located exclusively inside the oral cavity." They described the lesion as "indistinguishable from other pathologies such as salivary gland mucocoele or soft tissue neoplasm."

Foreign body granulomas can be successfully treated with intralesional or systemic corticosteroids, they noted. In this case, simple surgical excision was performed because it was a well-demarcated lesion.

Dr. da Costa and colleagues reported having no conflicts of interest.

Although a variety of injectable cosmetic fillers are in high demand, physicians should be aware that rare adverse reactions—like foreign body granulomas—are being reported, according to a case report.

Injectable permanent fillers containing polymethyl methacrylate (PMMA) immersed in a solution of collagen have been implicated in several types of adverse reactions, reported Dr. M.C. da Costa Miguel of the department of oral pathology at the Federal University of Rio Grande do Norte, Brazil, and his colleagues.

Foreign body granulomas only develop in some patients, and this particular granuloma formation caused by a reaction to injectable fillers is only observed in 0.01% of patients, further adding to the diagnostic challenge, the researchers wrote.

Dr. da Costa and his colleagues found the granulomas in a 56-year-old woman after performing a number of examinations. Initial examinations showed a "firm, pink nodule covered with non-ulcerated mucosa located in the right anterior inferior alveolar mucosa." The swelling was painless and moveable. There was no bone involvement, no palpable adenopathies, and the patient showed no symptoms of atopy (Int. J. Oral Maxillofac. Surg. 2009;38:385-7).

Salivary gland mucocoele was considered initiallly. After a biopsy, the researchers found that "immunohistochemical analysis using anti-CD68 antibody confirmed the presence of numerous macrophages and CD68-positive multinucleated giant cells."

The patient was asked if any aesthetic procedure had been performed close to the site of her swelling and she confirmed that she had an injection of a cosmetic filler containing PMMA for lip enlargement about 1 year earlier.

According to Dr. da Costa and his colleagues, what made this case particularly rare was its "unusual clinical presentation as a painless nodule located exclusively inside the oral cavity." They described the lesion as "indistinguishable from other pathologies such as salivary gland mucocoele or soft tissue neoplasm."

Foreign body granulomas can be successfully treated with intralesional or systemic corticosteroids, they noted. In this case, simple surgical excision was performed because it was a well-demarcated lesion.

Dr. da Costa and colleagues reported having no conflicts of interest.

Although a variety of injectable cosmetic fillers are in high demand, physicians should be aware that rare adverse reactions—like foreign body granulomas—are being reported, according to a case report.

Injectable permanent fillers containing polymethyl methacrylate (PMMA) immersed in a solution of collagen have been implicated in several types of adverse reactions, reported Dr. M.C. da Costa Miguel of the department of oral pathology at the Federal University of Rio Grande do Norte, Brazil, and his colleagues.

Foreign body granulomas only develop in some patients, and this particular granuloma formation caused by a reaction to injectable fillers is only observed in 0.01% of patients, further adding to the diagnostic challenge, the researchers wrote.

Dr. da Costa and his colleagues found the granulomas in a 56-year-old woman after performing a number of examinations. Initial examinations showed a "firm, pink nodule covered with non-ulcerated mucosa located in the right anterior inferior alveolar mucosa." The swelling was painless and moveable. There was no bone involvement, no palpable adenopathies, and the patient showed no symptoms of atopy (Int. J. Oral Maxillofac. Surg. 2009;38:385-7).

Salivary gland mucocoele was considered initiallly. After a biopsy, the researchers found that "immunohistochemical analysis using anti-CD68 antibody confirmed the presence of numerous macrophages and CD68-positive multinucleated giant cells."

The patient was asked if any aesthetic procedure had been performed close to the site of her swelling and she confirmed that she had an injection of a cosmetic filler containing PMMA for lip enlargement about 1 year earlier.

According to Dr. da Costa and his colleagues, what made this case particularly rare was its "unusual clinical presentation as a painless nodule located exclusively inside the oral cavity." They described the lesion as "indistinguishable from other pathologies such as salivary gland mucocoele or soft tissue neoplasm."

Foreign body granulomas can be successfully treated with intralesional or systemic corticosteroids, they noted. In this case, simple surgical excision was performed because it was a well-demarcated lesion.

Dr. da Costa and colleagues reported having no conflicts of interest.