Late-onset Migrated Inflammatory Granuloma After Collagen-Containing Filler Injection

Young Joon Jo; Deok Goo Lee; Sung Bok Lee

doi:10.3341/jkos.2008.49.8.1330

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008056

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Jo, Lee, and Lee: Late-onset Migrated Inflammatory Granuloma After Collagen-Containing Filler Injection

Original Article

J Korean Ophthalmol Soc 2008;49(8):1330-1334.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1330

Late-onset Migrated Inflammatory Granuloma After Collagen-Containing Filler Injection

Young Joon Jo, M.D.¹, Deok Goo Lee, M.D.¹, Sung Bok Lee, M.D.^1,²

Department of Ophthalmology, College of Medicine, Chungnam National University, Daejeon, Korea

Chungnam National University Research Institute for Medical Sciences, Daejeon, Korea

Address reprint requests to Sung Bok Lee, M.D. Department of Ophthalmology, Chungnam National University Hospital #640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea Tel: 82-42-280-7608, Fax: 82-42-255-3745, E-mail: sblee@cnu.ac.kr

Received 25 March 2008 Accepted 4 October 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of inflammatory granuloma in the right medial canthal area which occurred seven years after a cosmetic collagen-containing dermal filler injection in the forehead.

Case summary

A-47-year-old female, who had been treated with collagen-containing filler 7 years earlier, presented with a mass in the right medial canthal area discovered 20 days previously. There was mild tenderness and the mass was firm and not fixed. The patient reported that the size of the mass was slowly increasing. Orbital computed tomography and magnetic resonance imaging showed an approximate 1 cm-sized, poorly defined, enhancing nodular thickening without evidence of bony erosion. The mass was removed through a skin incision and unidentified foreign bodies were found around the mass. On histopathologic examination, it was diagnosed as inflammatory granuloma caused by foreign substances.

Conclusions

Collagen-containing fillers are widely used in cosmetic surgery for their lasting effect and few complications. However some complications such as inflammatory granuloma may occur at the injection site or other sites, even several years after operation.

Keywords: Collagen, Filler, Granuloma

References

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Figure 1.

Preoperative photograph. The hard, non-fixed and mild tender mass is palpated on the right medial canthal area (arrows).

Figure 2.

Preoperative orbital CT scan shows soft tissue swelling without bony erosion in the right medial canthal area (arrow).

Figure 3.

Preoperative orbital MRI findings. (A) On T1-weighted axial image, about 1 cm-sized, ill defined mass appears as an isosignal intensity with extraocular muscles in the right medial canthal area (arrow). (B) The mass is well enhanced on post-contrast T1-weighted axial image (arrowhead).

Figure 4.

Gross findings of the mass. (A) The mass (14×4 mm) is not encapsulated and has irregular surface. (B) Unidentified 2×1 mm and 1×1 mm sized foreign bodies are found around the mass. These are hard and translucent.

Figure 5.

Histopathologic findings of the mass. The mass is consisted of histiocytes, epitheloid cells and multinucleated giant cells (arrow). The mass has also numerous empty vacuoles. The mass was diagnosed as foreign body inflammatory granuloma. (Hematoxylin and eosin stain; original magnification ×400).

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