Granulomatous foreign-body reaction involving oral and perioral tissues after injection of biomaterials: a series of 7 cases and review of the literature.

Abstract

PURPOSE:

Injectable implants used for soft-tissue augmentation may lead to a granulomatous foreign-body reaction. The aim of this report is to present 7 new cases of foreign-body granulomas involving the oral and perioral tissues, after injection of biomaterials to achieve soft-tissue augmentation. In addition, the clinical and epidemiological profile of this condition is summarized, based on a review of the English-language literature of all previously described cases.

PATIENTS AND METHODS:

We report on 7 new cases of granulomatous foreign-body reaction involving the oral and perioral tissues after the injection of biomaterials. A comprehensive literature review is also presented.

RESULTS:

The literature search revealed 49 cases of this condition affecting the oral and perioral tissues. Our 7 patients were female, with a mean age of 52.8 years (range, 34 to 70 years). The lower lip was affected in 4 cases, 1 case was located in the upper lip, 1 case in the buccal mucosa, while 1 case involved 2 different sites (upper lip and buccal mucosa). Histopathologic examination revealed numerous cells with clear, often multiple, cytoplasmic vacuoles, bearing a resemblance to lipoblasts. Immunohistochemistry revealed diffuse positivity for the histiocytic marker CD68.

CONCLUSIONS:

The diagnosis of granulomatous foreign-body reactions may be challenging because of their microscopic resemblance to liposarcoma, and because of the occasional reluctance of patients to report the previously performed esthetic procedure. A clinical history, histopathologic examination, and immunohistochemical analysis (as needed) are essential in achieving an accurate diagnosis.

• Authors: Bruno C Jham, Nikolaos G Nikitakis, Mark A Scheper, John C Papadimitriou, Bernard A Levy, Helen Rivera
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 67 Issue 2 Pg. 280-5 (Feb 2009) ISSN: 1531-5053 [Electronic] United States
• PMID: 19138600 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Biocompatible Materials
• Biopolymers
• Collagen

Topics

• Adult
• Aged
• Biocompatible Materials (adverse effects)
• Biopolymers (adverse effects)
• Body Modification, Non-Therapeutic (adverse effects)
• Collagen (adverse effects)
• Cosmetic Techniques (adverse effects)
• Diagnosis, Differential
• Female
• Granuloma, Foreign-Body (chemically induced, diagnosis)
• Humans
• Injections (adverse effects)
• Lip
• Lip Neoplasms (diagnosis)
• Lipoma (diagnosis)
• Middle Aged
• Mouth Mucosa
• Tissue Expansion (adverse effects)