Einstein International Journal Organization(EIJO)

Abstract

Rationale: A foreign body granuloma is a cellular attempt to contain any offending agent which couldn’t be eradicated. Foreign body granuloma of extremities are very often reported however those of face are very rare. They pose a diagnostic challenge and get reported only if patients turn symptomatic.

Patient concerns: We report a case of a 24 year old male patient visiting our OPD with a swelling over right cheek region following an accident 5 months back. The patient was concerned about his face being ‘deformed’.

Diagnosis, Intervention and Outcome: Radiology was of little help in the diagnosis. Surgical exploration under local anesthesia was performed with patient’s consent. A thorn enclosed within a granulomatous pouch was recovered suggesting foreign body granuloma.

Lessons: Surgical intervention should be made after informing risks like facial nerve injury, stenson duct damage, post-operative ectropion, scar etc.

Keywords: Foreign Body, Foreign Body Granuloma, Abscess, Facial Nerve, Implantation Dermoid

Reference

1. Bouajina E, Harzallah L, Ghannouchi M, Hamdi I, Rammeh N, Ben Hamida R, et al : Foreign body granuloma due to unsuspected wooden splinter. Joint Bone Spine.2006; 73 : 329-31
2. Harris EJ. Retained hawthorn fragment in a child's foot complicated by infection: diagnosis and excision aided by localization with ultrasound. The Journal of foot and ankle surgery. 2010 Mar 1;49(2):161-5.
3. Bae, JM, Kim, MY, Kang, H, Park, CJ, Park, YM, and Cho, SH . The clinicopathologic study of foreign body granuloma induced by injection of filler. Korean J Dermatol. 2007;45:255-61.
4. Curiel AV, Romon MV, Lucia FC, Bermundo MR, Bencano AC. Injuries from palm tree thorn simulating tumoral or pseudotumoral bone lesions. Acta orthopaedica belgica. 2001;67(3):279-82.
5. Peterson JJ, Bancroft LW, Kransdorf MJ. Wooden foreign bodies: Imaging appearance. AJR Am J Roentgenol. 2002;178:557-62.  
6. Bodne D, Quinn SF, Cochran CF. Imaging foreign glass and wooden bodies of the extremities with CT and MR. J Comput Assist Tomogr 1988;12:608-11.
7. Nogueira RVB, Vasconcelos BCE. Facial nerve injury following surgery for the treatment of ankylosis of the temporomandibular joint. Med Oral Patol Oral Cir Bucal 2007;12:E160-5.
8. Bouajina E, Harzallah L, Ghannouchi M, et al. Foreign body granuloma due to unsuspected wooden splinter. Joint Bone Spine. 2006 May;73(3):329-331. DOI: 10.1016/j.jbspin.2005.04.009.
9. Berk T,  Pape HC, Jukema GN.Perforating foreign body causing incomplete facial paralysis.Trauma Case Reports.2020;Volume 30:ISSN 2352-6440, https://doi.org/10.1016/j.tcr.2020.100370.
10. Rai H, Shaila M, Ghosh G and Suhasini PD  Foreign body giant cell granuloma of the mandible subsequent to endodontic surgery. J. Contemp. Dent. 2015;5: 178–180.
11. Perkins IU, Gardner JM, Stuart LN. Foreign body reaction. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorforeignbodyreaction.html. Accessed January 18th, 2021.
12. Joyce, S., Rao Sripathi, B. H., Mampilly, M. O., Firdoose Nyer, C. S. Foreign body granuloma. Journal of maxillofacial and oral surgery.2014;13(3):351–354. https://doi.org/10.1007/s12663-010-0113-9
13. Teixeira D, Louzeiro G,Bortolli J, Farina G,  Figueiredo M, Cherubini K, Salum F.Orofacial Granulomas After Injection Of Cosmetic Fillers: A Case Report. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2020;129 (1),Page e78.