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Yang Y, Yan J, Yang J, Wang P, Liu Y, Wang X. Janus kinase inhibitor Abrocitinib as an Off-Label treatment for tattoo granuloma with uveitis (TAGU). Australas J Dermatol 2024; 65:297-299. [PMID: 38450752 DOI: 10.1111/ajd.14248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Yutong Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yeqiang Liu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
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2
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Waelti SL, Fandak J, Markart S, Willems EP, Wildermuth S, Fischer T, Dietrich TJ, Matissek C, Krebs T. Prospective evaluation of ultrasound features of magnesium-based bioabsorbable screw resorption in pediatric fractures. Eur Radiol 2024; 34:1556-1566. [PMID: 37658140 DOI: 10.1007/s00330-023-10091-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/27/2023] [Accepted: 07/04/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Bioabsorbable magnesium-based alloy screws release gas upon resorption. The resulting findings in the adjacent soft tissues and joints may mimic infection. The aim of the study was to evaluate the ultrasound (US) findings in soft tissues and joints during screw resorption. METHODS Prospectively acquired US studies from pediatric patients treated with magnesium screws were evaluated for screw head visibility, posterior acoustic shadowing, twinkling artifact, foreign body granuloma, gas (soft tissue, intra-articular), alterations of the skin and subcutaneous fat, perifascial fluid, localized fluid collections, hypervascularization, and joint effusion. RESULTS Sixty-six US studies of 28 pediatric patients (nfemale = 9, nmale = 19) were included. The mean age of the patients at the time of surgery was 10.84 years; the mean time between surgery and ultrasound was 128.3 days (range = 6-468 days). The screw head and posterior acoustic shadowing were visible in 100% of the studies, twinkling artifact in 6.1%, foreign body granuloma in 92.4%, gas locules in soft tissue in 100% and intra-articular in 18.2%, hyperechogenicity of the subcutaneous fat in 90.9%, cobblestoning of the subcutaneous fat in 24.2%, loss of normal differentiation between the epidermis/dermis and the subcutaneous fat in 57.6%, localized fluid collection in 9.9%, perifascial fluid in 12.1%, hypervascularization in 27.3%, and joint effusion in 18.2%. CONCLUSION US findings in pediatric patients treated with magnesium screws strongly resemble infection, but are normal findings in the setting of screw resorption. CLINICAL RELEVANCE STATEMENT Bioabsorbable magnesium-based alloy screws release gas during resorption. The resulting US findings in the adjacent soft tissues and joints in pediatric patients may mimic infection, but are normal findings. KEY POINTS • Bioabsorbable magnesium-based alloy screws release gas upon resorption. • The resulting ultrasound findings in children's soft tissues and joints closely resemble those of soft tissue infection or osteosynthesis-associated infection. • Be familiar with these ultrasound findings in order to avoid inadvertently misdiagnosing a soft tissue infection or osteosynthesis-associated infection.
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Affiliation(s)
- Stephan L Waelti
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland.
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
| | - Jozef Fandak
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Stefan Markart
- Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Erik P Willems
- Clinical Trials Unit, Biostatistics, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Simon Wildermuth
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Tim Fischer
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Tobias J Dietrich
- Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christoph Matissek
- Department of Pediatric Surgery, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Thomas Krebs
- Department of Pediatric Surgery, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
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Lumbiganon S. Reply to "Comment to: 'Surgical treatment of penile foreign body granuloma: Penile shaft reconstruction with single- versus two-stage scrotal flap techniques'". Int J Urol 2024; 31:187. [PMID: 38069468 DOI: 10.1111/iju.15359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Affiliation(s)
- Supanut Lumbiganon
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Innocenti A, Andreoli AL. Comment to: "Surgical treatment of penile foreign body granuloma: Penile shaft reconstruction with single- versus two-stage scrotal flap techniques". Int J Urol 2024; 31:185-186. [PMID: 37798839 DOI: 10.1111/iju.15316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
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Itoh N, Takayama G, Kitamura G, Shimauchi Y, Mizutani T, Hikami S, Aratani K, Ujiie K, Yoneda M, Nakamura Y, Takemura M, Koike H, Kakihara N, Ikawa O, Okano S. [A Resected Case of Intraperitoneal Foreign Body Granuloma Mimicking Peritoneal Dissemination]. Gan To Kagaku Ryoho 2023; 50:1501-1503. [PMID: 38303321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Foreign body granuloma(FBG)is a granuloma that occurs due to chronic inflammation caused by various residual foreign objects. In the field of gastrointestinal surgery, intraperitoneal foreign body granulomas(IPFBGs)are often caused by sutures materials or residual gauzes, but those caused by food residue are extremely rare. We present an IPFBG case of food residue caused by anastomotic leakage, which was difficult to be distinguished from peritoneal dissemination. The patient is a 74- year-old male. Anastomotic leakage occurred following low anterior resection for rectal cancer, peritoneal drainage and ileostomy were performed. 1.5 years after rectal resection, liver metastasis was diagnosed by CT and peritoneal dissemination was diagnosed by PET-CT. Both lesions were resected at the same time. The pathological findings were liver metastasis and FBG. It was presumed to be an FBG formed by food residue left behind after anastomotic leakage. It has reported that FBG caused by residual gauzes were shown a ring-shaped uptake by PET-CT, but that was not observed in our case. In addition, since a nodule suspected of liver metastasis was observed simultaneously, we considered no differential diagnosis other than peritoneal dissemination. IPFBG resembling peritoneal dissemination, occurred after anastomotic leakage. A food residue can cause IPFBG, it is necessary to consider IPFBG in decision making treatment strategy for peritoneal nodule.
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Affiliation(s)
- Norio Itoh
- Dept. of Surgery, Japanese Red Cross Kyoto Daini Hospital
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Lumbiganon S, Pachirat K, Sirithanaphol W, Rompsaithong U, Kiatsopit P, Nuwatkrisin K. Surgical treatment of penile foreign body granuloma: Penile shaft reconstruction with single- versus two-stage scrotal flap techniques. Int J Urol 2023; 30:681-687. [PMID: 37257041 DOI: 10.1111/iju.15209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/10/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To report outcomes of surgical treatment in patients with penile foreign body granuloma and compare surgical outcomes between single- and two-stage scrotal flap reconstructions. METHODS Medical records of patients with penile foreign body granuloma who underwent surgical treatment were reviewed. Patients with single- and two-stage scrotal flap reconstructions were compared. RESULTS Forty-two patients underwent surgical treatment from January 1, 2018 to October 31, 2022. Twenty-three patients underwent single-stage reconstruction with bilateral scrotal flap while 12 patients underwent two-stage repair with 19 operations. Five patients underwent circumcision; one had excision with primary closure. Another patient underwent reconstruction by penile skin preservation technique. There was no statistically significant differences between single- and two-stage groups in wound infection (8.69% vs. 0%, RR 2.71, 95%CI; 0.14-52.29), wound dehiscence (21.74% vs. 8.33%, RR 2.61, 95%CI 0.34-19.87), reoperation rate (26.08% vs. 8.33%, RR 3.13, 95%CI; 0.42-23.10). Postoperative fever was significantly higher in single-stage group (56.52 vs. 8.33%, RR 6.78, 95%CI; 1.01-43.83). Total length of hospital stay was shorter in single-stage group (7.43 ± 3.19 days vs. 10.86 ± 1.57 days, MD -3.42, 95%CI; -5.28 to -1.57). Incidence of patients without Clavien-Dindo surgical complications was significantly lower in single-stage group (43.48% vs. 83.33%, RR 0.53, 95%CI; 0.31-0.89). CONCLUSIONS Both single- and two-stage techniques may be considered for penile foreign body granuloma reconstruction. Although the hospital stay was longer in two-stage group, the complication rates were lower.
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Affiliation(s)
- Supanut Lumbiganon
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kachit Pachirat
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wichien Sirithanaphol
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ukrit Rompsaithong
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pakorn Kiatsopit
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kanrapee Nuwatkrisin
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Madan S, Beri S, Yadav N. Spontaneous resolution of a wooden foreign-body granuloma in the conjunctiva of a child. Natl Med J India 2023; 36:231-232. [PMID: 38692639 DOI: 10.25259/nmji_562_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
A conjunctival foreign-body (FB) granuloma may result following trauma with synthetic and non-synthetic materials including organic and non-organic objects. Children usually manifest with FB granulomas that develop due to inoculation of FBs from soft toys, blankets or woollen clothes. Encapsu- lation of these FBs following a granulomatous inflammatory response results in a nodular swelling in the conjunctiva. Reports of a wooden FB granuloma in the conjunctiva in children are anecdotal. A 5-year-old boy suffered an un- witnessed direct ocular trauma to his left eye (OS) with a wooden arrow while playing. He developed redness and nodular swelling at the inferotemporal aspect of the OS without any visual complaints. The diagnosis of a wooden FB granuloma is a challenge to ophthalmologists and may go undetected in children who neglect their symptoms. It characteristically presents as a unilateral conjunctival nodule. Surgical excision is the definitive management. However, spontaneous extrusion of the FB might be observed due to protective blinking and tearing mechanisms in the eye.
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Affiliation(s)
- Siddharth Madan
- Department of Ophthalmology, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, New Delhi, India
| | - Sarita Beri
- Department of Ophthalmology, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, New Delhi, India
| | - Nishant Yadav
- Department of Ophthalmology, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, New Delhi, India
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Neerukonda VK, Lefebvre D, Chatson GP, Stagner AM. Silicone Granulomas of the Eyelids-A Case Series Illustrating a Distant Migratory Phenomenon. Ophthalmic Plast Reconstr Surg 2023; 39:81-87. [PMID: 36136734 DOI: 10.1097/iop.0000000000002255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Exogenous silicone has been reported to migrate to anatomic sights far from an initial injection or implantation site; this phenomenon has been rarely described in the ocular adnexa, especially in the eyelids. We document 3 additional cases of distant migration of silicone implanted elsewhere in the body to the eyelids and review the prior literature on this uncommon event. METHODS A retrospective chart review of 3 patients was conducted along with analysis of diagnostic histopathology. A comprehensive review of the literature regarding dissemination or migration of silicone to the eyelids in patients with either silicone breast implants or silicone facial filler use was performed. RESULTS Cases of silicone migrating to the eyelids from silicone breast implants and silicone-based facial filler are outlined in Tables 1 and 2, respectively. There are 4 total reports of women with silicone breast implants, including the 2 described here, with evidence of migration of silicone to the eyelid. Similarly, 5 cases of silicone-based facial filler with resultant migration of filler to the eyelids were identified, including 2 of the cases presented in this report (1 patient had both silicone breast implants and silicone facial filler). CONCLUSION Silicone is chemically inert, but is known to travel throughout the body, causing a resultant foreign body response in tissue that can adversely affect even the eyelids. Silicone has a relatively characteristic histologic appearance and diagnosis of silicone granuloma highlights the importance of obtaining a thorough clinical history, particularly regarding prior cosmetic injections or breast enhancement surgery. Foreign material/foreign body granuloma is important to consider in patients with deep eyelid nodules of unclear etiology.
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Affiliation(s)
- Vamsee K Neerukonda
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Daniel Lefebvre
- Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
- Surgical Service-Ophthalmology, Boston VA Healthcare System, Jamaica Plain, Massachusetts, U.S.A
| | - George P Chatson
- Chestnut Green at The Andovers, North Andover, Massachusetts, U.S.A
- Nashua Plastic Surgery, North II Specialty, Nashua, New Hampshire, U.S.A
| | - Anna M Stagner
- David G. Cogan Laboratory of Ophthalmic Pathology, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
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9
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Liu WJ, Wang N, Fu Y, Song ZY. [Middle ear cholesterol granuloma due to foreign body: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:741-742. [PMID: 35725320 DOI: 10.3760/cma.j.cn115330-20220311-00106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- W J Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China
| | - N Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China
| | - Y Fu
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China
| | - Z Y Song
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, China
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10
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Chen W, Gong T, Elston D, Ji C. Foreign body granulomas caused by caterpillar setae. BMJ Case Rep 2022; 15:e248653. [PMID: 35641088 PMCID: PMC9157333 DOI: 10.1136/bcr-2021-248653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Wen Chen
- Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Ting Gong
- Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dirk Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Chao Ji
- Dermatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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11
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Kiilerich CH, Carstensen LF. [Breast implant rupture can mimic disseminated cancer]. Ugeskr Laeger 2022; 184:V09210700. [PMID: 35593368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Silicone-induced granuloma is a well-known, but rare delayed complication of implantation of silicone breast prostheses and consists of a foreign body reaction with encapsulation of free silicone, most often due to implant rupture with silicone leakage. We present a case report of a patient with a silicone-induced granuloma. On a PET/CT silicone-induced granuloma can mimic disseminated cancer.
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12
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Corrales MF, Restrepo R, Calle E, Morales D. Biopolymer sarcoid-like foreign-body granulomas: Case report and literature review. Biomedica 2022; 42:8-16. [PMID: 35866725 PMCID: PMC9365448 DOI: 10.7705/biomedica.6059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/25/2021] [Indexed: 06/15/2023]
Abstract
Iatrogenic allogenosis is a disease caused by the injection of biopolymers with esthetic purposes. Clinical manifestations can occur between six hours and 30 years after the procedure with local and/or systemic symptoms. The pathological findings are characterized by the presence of foreign body granulomas with a sarcoid-like reaction. Its interpretation is difficult given its association with sarcoidosis. We report the clinical case of a female patient with granulomatous lesions in reaction to a foreign body secondary to the multiple application of unknown substances on the face and buttocks.
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Affiliation(s)
| | | | - Estefanía Calle
- Grupo de Investigación, Universidad CES, Medellín, Colombia.
| | - Daniela Morales
- Grupo de Investigación, Universidad CES, Medellín, Colombia.
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Affiliation(s)
- Ko Matsuoka
- Department of Dermatology (Matsuoka, Tanaka, Nomura), Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Dermatology (Matsuoka), Tsuchiura Kyodo General Hospital, Tsuchiura, Japan; Department of Dermatology (Tanaka), Mito Saiseikai General Hospital, Mito, Japan
| | - Ryota Tanaka
- Department of Dermatology (Matsuoka, Tanaka, Nomura), Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Dermatology (Matsuoka), Tsuchiura Kyodo General Hospital, Tsuchiura, Japan; Department of Dermatology (Tanaka), Mito Saiseikai General Hospital, Mito, Japan
| | - Toshifumi Nomura
- Department of Dermatology (Matsuoka, Tanaka, Nomura), Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Dermatology (Matsuoka), Tsuchiura Kyodo General Hospital, Tsuchiura, Japan; Department of Dermatology (Tanaka), Mito Saiseikai General Hospital, Mito, Japan
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14
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Leight-Dunn H, Lemly V, Chapas A. Delayed Granulomatous Reaction After Eyebrow Microblading. Dermatol Surg 2022; 48:142-143. [PMID: 34537782 DOI: 10.1097/dss.0000000000003236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Abrouk M, Brodsky M, Pol-Rodriguez M, Soleymani T. Successful Management of Disseminated and Disfiguring Silicone Granulomatosis. Dermatol Surg 2021; 47:1680-1682. [PMID: 34743127 DOI: 10.1097/dss.0000000000003254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Michael Abrouk
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Merrick Brodsky
- University of Colorado Department of Dermatology, Denver, Colorado
| | | | - Teo Soleymani
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California
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16
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Heitmiller K, Albornoz C, Saedi N, MacGregor J. Foreign Body Granuloma Secondary to a Ruptured Cyst After Dermal Filler Injection. Dermatol Surg 2021; 47:1522-1524. [PMID: 34387277 DOI: 10.1097/dss.0000000000003210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kerry Heitmiller
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Christian Albornoz
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Nazanin Saedi
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jennifer MacGregor
- Department of Dermatology, Union Square Laser Dermatology, New York, New York
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Sermsathanasawadi N, Pruekprasert K, Chinsakchai K, Wongwanit C, Ruangsetakit C. Cyanoacrylate Granuloma After Cyanoacrylate Closure of Incompetent Saphenous Veins. Dermatol Surg 2021; 47:1372-1375. [PMID: 34347695 PMCID: PMC8460077 DOI: 10.1097/dss.0000000000003183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cyanoacrylate closure (CAC) is a minimally invasive surgery to treat incompetent saphenous veins. OBJECTIVE To evaluate the incidence, the risk factors for, and the management of cyanoacrylate granuloma (CAG) after CAC of incompetent saphenous veins in patients with chronic venous disease. MATERIALS AND METHODS Data specific to incompetent saphenous veins, including great saphenous veins, anterior accessory saphenous veins, and small saphenous veins, that were treated with CAC were retrospectively evaluated. RESULTS A total of 126 saphenous veins from 101 patients were included. Recapture of the delivery catheter before withdrawal was not performed in all patients. Cyanoacrylate granuloma occurred in 3 of 101 (2.9%) patients, and in 3 of 126 (2.3%) treated saphenous veins. All patients with CAG presented with granuloma and abscess at the puncture site 3 to 5 months after CAC. All patients were treated with incision, drainage, and removal of the glue foreign body. No recurrent granuloma was observed during the study period. No patient or procedural predictive factor for CAG was identified. CONCLUSION Cyanoacrylate granuloma is not a rare complication after CAC when recapture of the delivery catheter is not performed. Patients should be advised of the possibility of CAG after CAC.
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Affiliation(s)
- Nuttawut Sermsathanasawadi
- All authors are affiliated with the Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanin Pruekprasert
- All authors are affiliated with the Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Khamin Chinsakchai
- All authors are affiliated with the Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chumpol Wongwanit
- All authors are affiliated with the Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chanean Ruangsetakit
- All authors are affiliated with the Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Kok KYY, Telisinghe PU, Tripathi S. Fine-Needle Aspiration Cytology in the Diagnosis of Breast Paraffinoma. Acta Cytol 2021; 65:478-482. [PMID: 34515047 DOI: 10.1159/000518453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Paraffin injections for breast augmentation once a popular form of mammoplasty are now considered obsolete. It had been abandoned by clinicians because of its associated serious complications. The practice is however still available and is being practiced by nonmedically qualified people. Paraffin injection results in the formation of multiple foreign-body granulomas known as breast paraffinoma. The clinical features of breast paraffinoma can mimic and be mistaken for breast carcinoma or inflammatory breast carcinoma. The use of fine-needle aspiration cytology (FNAC) in the evaluation of patients with breast paraffinoma has not been fully evaluated. METHODS Retrospective review was performed on 30 patients who presented with breast paraffinoma between June 1, 2010, and June 30, 2020, who also had FNAC as part of their breast lump evaluation. RESULTS FNAC of 73.3% patients showed multinucleated giant cells and macrophages or histiocytes containing engulfed clear, empty intracytoplasmic vacuoles of varying sizes. In 13.3% of the patients, macrophages or histiocytes with engulfed clear intracytoplasmic vacuoles of varying sizes were seen. In 6.7% of patients, multinucleated giant cells containing engulfed vacuoles of varying sizes were seen, and in 6.7% of patients, hypocellular smears with large amount of clear spaces were seen. Oily droplets were seen in the background of all the smears, and there were no malignant cells seen. These features were compatible with breast paraffinoma. CONCLUSION Most patients with breast paraffinoma can be managed conservatively and they do not require further treatment; FNAC with its characteristic features can provide the reliable diagnosis of breast paraffinoma and therefore sparing these patients from more invasive diagnostic procedures.
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Affiliation(s)
- Kenneth Y Y Kok
- Discipline of Medicine, Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
| | | | - Sonal Tripathi
- Department of Surgery, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei
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Pesce K, Wercnike A, Chico MJ, Segura Chuquillanqui SL. [Cholesterol granuloma in the breast]. Medicina (B Aires) 2021; 81:1089. [PMID: 34875618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Affiliation(s)
- Karina Pesce
- Sección Diagnóstico e Intervencionismo Mamario, Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Argentina. E-mail:
| | - Alejandra Wercnike
- Servicio de Anatomía Patológica Hospital Italiano de Buenos Aires, Argentina
| | - María José Chico
- Sección Diagnóstico e Intervencionismo Mamario, Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Argentina
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Abstract
Foreign body granulomas can develop even several years after autologous fat or filler injection. In some instances the foreign body granulomas have been found at sites other than the original injection site. We present a case of a 48-year-old male with reported "hyaluronic acid fillers" injected into his upper and lower eyelids several years prior. He subsequently developed periorbital swelling with negative allergic and rheumatologic workup. The patient ultimately underwent a blepharoplasty for improvement of the swelling. Histopathology suggested silicone granulomas of the upper and lower eyelid. This case illustrates the importance of keeping foreign body granulomas on the differential for all patients with a history of facial dermal filler injections. Although hyaluronic acid is the most common dermal filler, providers should suspect the use of other dermal fillers including those not FDA approved particularly when common conservative treatment methods are not sufficient.
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Affiliation(s)
- Jacqueline A Wulu
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Laura Garcia-Rodriguez
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Andrey Prilutskiy
- Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Jeffrey H Spiegel
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA 02118, United States of America; The Spiegel Center Newton, MA 02459, United States of America.
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21
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Nowak DA, Sladden C. Barber's sinus between the toes of a female hairdresser. Cutis 2019; 104:E32-E33. [PMID: 31675410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Dominik Alex Nowak
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Christopher Sladden
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
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22
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Díaz-Cabanas L, Belani-Raju M, González-Márquez PI, Artioli-Schellini S, Guereñu-Panero I, Galindo-Ferreiro A. Sarcoidosis in the periocular scar as the first finding of systemic sarcoidosis: Clinical-radiological characteristics. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:453-459. [PMID: 31036427 DOI: 10.1016/j.oftal.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/01/2019] [Accepted: 03/15/2019] [Indexed: 06/09/2023]
Abstract
An unusual case is presented of a 29 year-old Caucasian woman with a granuloma in an old scar in the right periocular region as a first clinical sign of a systemic sarcoidosis. An excisional biopsy was performed, for which the histological diagnosis was a chronic non-necrotising granulomatous inflammation, suggestive of scar sarcoidosis. The lesion re-appeared one year after initial treatment, and was treated with intralesional depot steroids, showing adequate progression. This disease occurs more frequently in wound areas where there are foreign bodies and could be the first sign of systemic sarcoidosis.
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Affiliation(s)
- L Díaz-Cabanas
- Departamento de Oftalmología, Hospital Clínico Universitario, Valladolid, España.
| | - M Belani-Raju
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
| | - P I González-Márquez
- Servicio de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, España
| | - S Artioli-Schellini
- Departamento de Oftalmología, Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brazil
| | - I Guereñu-Panero
- Servicio de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, España
| | - A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
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Parulan MAA, Sundar G, Lum JH, Ramachandran U. A case report on dermal filler-related periorbital granuloma formation. Orbit 2019; 38:169-172. [PMID: 29842814 DOI: 10.1080/01676830.2018.1477806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/13/2018] [Indexed: 06/08/2023]
Abstract
We report a case of a 49-year old East-Asian female who presented with delayed onset granuloma formation at the right medial lower eyelid area. The clinical and radiologic presentation with pathologic correlation following synthetic hyaluronic acid filler injection and its management are described along with a review of literature following dermal-filler injections types. Dermal-filler-related granuloma formation should be included in the differential diagnoses of periorbital inflammatory and mass lesions. It is recommended that clinicians who perform this procedure should discuss these risks and possible late complications with patients and provide them with the relevant product information of the injected filler for appropriate management should such early or late complications occur.
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Affiliation(s)
| | - Gangadhara Sundar
- a Ophthalmology Department , National University Health System (NUHS) , Singapore
| | - Jeffrey Hy Lum
- b Pathology Department , National University Health System (NUHS) , Singapore
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Akhaddar A, Turgut AT, Turgut M. Foreign Body Granuloma After Cranial Surgery: A Systematic Review of Reported Cases. World Neurosurg 2018; 120:457-475. [PMID: 30267951 DOI: 10.1016/j.wneu.2018.09.143] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/16/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND In cranial surgery, different foreign body (FB) materials are used and may be left intentionally or unintentionally in the surgical field after closure, inducing a foreign body granuloma (FBG). This is a rare complication in neurosurgery, but it may be a diagnostic dilemma, with sometimes medicolegal implications. METHODS We performed a systematic review of the English literature between 1965 and 2018 and found a total of 77 articles concerning 100 cases of FBG caused by retained material located within the cranium or surrounding soft tissues. RESULTS There were 60 females and 40 males, with ages ranging from 1 to 77 years. Most initial diagnoses were cranial/intracranial tumors, trigeminal neuralgia, hemifacial spasm, intracranial aneurysm, hydrocephalus, head injury, infectious disease, and nontraumatic intracerebral hematoma. The interval from the causative surgical operation to presentation of the FBG ranged from 2 weeks to 20 years. Various radiologic modalities were used and histologic study confirmed the presence of FBG in all patients. Intentional FB was used and left in 77 patients, and unintentional FB was found postoperatively in 23 patients. Associated infection was found in 13 patients. Complete recovery was seen in 47.6% of patients with sufficient data. CONCLUSIONS Despite being unusual, a retained FBG should be considered in the differential diagnosis of any patient after cranial surgery. A history of surgery, clinical symptoms, physical examination findings, laboratory results, and the use of appropriate neuroimaging explorations may provide a correct preoperative diagnosis. In addition, unintentionally retained FBs are preventable errors in the operating room.
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Affiliation(s)
- Ali Akhaddar
- Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V University in Rabat, Rabat, Morocco.
| | - Ahmet T Turgut
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mehmet Turgut
- Department of Neurosurgery, Adnan Menderes University School of Medicine, Aydın, Turkey
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Goret CC, Goret NE, Ozkan OF, Karaayvaz M. A remnant suture can mimic malignancy after total thyroidectomy. Ann Ital Chir 2018; 7:S2239253X18028402. [PMID: 30246700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Foreign body reactions may develop against exogenous or certain endogenous materials. Cases of suture granuloma that develop against nonabsorbable suture material are rare complications of thyroid surgery. Because of these postoperative complications, a history of cancer prior to the operation suggests recurrence of cancer. Appropriate clinical, radiological, and pathological evaluation is highly important in such cases. Postoperative foreign bodies may remain undetected for years, but they sometimes cause lethal complications. KEY WORDS Cancer mimicking, Foreign body, Suture granuloma, Thyroid surgery.
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Reverso-Meinietti J, Vandenbos F, Risso K, Coyne J, Leroy S, Padovani B, Burel-Vandenbos F. [Pulmonary intravascular talcosis: A case report]. Rev Med Interne 2018; 39:658-660. [PMID: 29650301 DOI: 10.1016/j.revmed.2018.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/22/2018] [Accepted: 03/09/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Pulmonary intravascular talcosis is a rare condition occurring in intravenous drug users injecting oral medications. Talc results in a foreign-body granulomatous reaction giving a radiological haematogenic miliary appearance mimicking miliary tuberculosis. Drug users represent a population at risk for both these conditions and their distinction may be challenging. CASE REPORT We reported the case of a man, 33 year-old, intravenous drug addict, detected by the health services because he was the partner of a person who died of contagious and multi-resistant tuberculosis. Chest X-ray and CT scan showed a typical miliary appearance. Despite negative microbiology, clinical diagnosis of miliary tuberculosis was retained. Due to the lack of radiological improvement despite appropriate antibiotic treatment, re-evaluation and trans-bronchial biopsy were undertaken. The presence of granulomas centered by birefringent foreign bodies in polarized light led to a diagnosis of pulmonary intravascular talcosis. CONCLUSION In the presence of pulmonary miliary in an intravenous drug addict, intravascular talcosis should be suspected.
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Affiliation(s)
- J Reverso-Meinietti
- Laboratoire central d'anatomie pathologique, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie Romaine, 06000 Nice, France
| | - F Vandenbos
- Centre de soins de suite et de rééducation cardiorespiratoire « La Maison du Mineur », 755, avenue Henri-Giraud, 06140 Vence, France
| | - K Risso
- Service de maladies infectieuses et tropicales, hôpital l'Archet I, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - J Coyne
- Laboratoire central d'anatomie pathologique, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie Romaine, 06000 Nice, France
| | - S Leroy
- Service de pneumologie, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie romaine, 06000 Nice, France
| | - B Padovani
- Service de radiologie, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie romaine, 06000 Nice, France
| | - F Burel-Vandenbos
- Laboratoire central d'anatomie pathologique, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie Romaine, 06000 Nice, France.
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Lee KC, Eisig SB, Perrino MA. Foreign Body Giant Cell Reaction to a Proplast/Teflon Interpositional Implant: A Case Report and Literature Review. J Oral Maxillofac Surg 2018; 76:1719-1724. [PMID: 29608904 DOI: 10.1016/j.joms.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 11/17/2022]
Abstract
After discectomy, interpositional implants (IPIs) are believed to provide temporomandibular joint stability and protect against degenerative joint space remodeling. Alloplastic IPIs gained popularity in the late 1970s because the practice showed early success without donor site morbidity. Unfortunately, these implants were subject to substantial fragmentation resulting in an exuberant foreign body giant cell response that progressively eroded adjacent structures. Most of these alloplastic implants were removed in the years following their recall by the US Food and Drug Administration in 1991, however some remained in circulation. This report describes a case of a failed Proplast/Teflon IPI 27 years after its placement. This case highlights the considerations for managing a patient with a Proplast/Teflon IPI and serves to remind providers that, although increasingly rare, these implants are still present and subject to delayed failure.
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Affiliation(s)
- Kevin C Lee
- Resident, Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, NY.
| | - Sidney B Eisig
- Chairman, Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, NY
| | - Michael A Perrino
- Assistant Professor, Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, NY
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Qin Y, Lu Y, Zheng L, Liu H. Ghost cell odontogenic carcinoma with suspected cholesterol granuloma of the maxillary sinus in a patient treated with combined modality therapy: A case report and the review of literature. Medicine (Baltimore) 2018; 97:e9816. [PMID: 29443742 PMCID: PMC5839843 DOI: 10.1097/md.0000000000009816] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Ghost cell odontogenic carcinoma (GCOC) is a rare malignant odontogenic tumor with aggressive growth characteristics. PATIENT CONCERNS A 41-year-old Chinese male visited our hospital in 2013, with a 4-month history of bloody purulent rhinorrhea with a peculiar smell in the right nasal cavity. DIAGNOSES The patient suffered from recurrent GCOC with suspected cholesterol granuloma of the maxillary sinus. The patient was incorrectly diagnosed with a calcifying epithelial odontogenic tumor at his first recurrence. Physical examination, radiological examination, and histopathology were used to identify GCOC. INTERVENTIONS Considering the recurrence of GCOC and poor effects of single surgery, postoperative adjuvant chemotherapy and concurrent chemoradiotherapy were performed after radical surgical excision. OUTCOMES So far, no significant evidence has suggested recurrence or metastasis after a long-term follow-up. LESSONS We advocate wide surgery with clean margins at the first accurate diagnosis. Combined modality therapy could be taken for the recurrent GCOC. We expect to provide a new treatment strategy to prevent the growth of this neoplasm.
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Affiliation(s)
| | | | | | - Hong Liu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Staloch DA, Hedley JS. Pulmonary Foreign-Body Granulomatosis. N Engl J Med 2017; 377:1273. [PMID: 28953434 DOI: 10.1056/nejmicm1701787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Cetin N, Sav NM, Ciftci E, Yildiz B. Foreign Body Reaction to Dialysis Chatheter and Peritoneal Fluid Eosinophilia in a Child on Continuous Ambulatory Peritoneal Dialysis. Iran J Kidney Dis 2017; 11:319-321. [PMID: 28794295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 12/11/2016] [Indexed: 06/07/2023]
Abstract
Foreign body reaction is a tissue response against implanted materials. We described for the first time the eosinophilic peritonitis and foreign body giant cell reaction to dialysis catheter in a nonatopic child on continuous ambulatory peritoneal dialysis. We found tenderness, redness, and swelling without purulent discharge around the peritoneal catheter; increased eosinophil count in cloudy dialysis fluid; and blood and hyperechoic granulomatous formation appearance surrounding the peritoneal catheter on ultrasonography and foreign body giant cell reaction to dialysis catheter in pathologic examination of granulomatous lesionin in our patient. The peritoneal dialysis catheter was removed due to resistance to antibiotic and antihistamine treatments for suspected peritonitis and tunnel infection. Foreign body reaction and eosinophilic peritonitis with eosinophilic cloudy dialysis effluent can exist simultaneously. Foreign body reaction should be considered in the differential diagnosis of exit site and/or tunnel infection. Ultrasonography helps distinguish between foreign body reaction and exit-site or tunnel infection.
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MESH Headings
- Adolescent
- Ascitic Fluid/immunology
- Biopsy
- Catheters, Indwelling/adverse effects
- Device Removal
- Eosinophilia/diagnosis
- Eosinophilia/etiology
- Eosinophilia/immunology
- Eosinophilia/therapy
- Granuloma, Foreign-Body/diagnosis
- Granuloma, Foreign-Body/etiology
- Granuloma, Foreign-Body/immunology
- Granuloma, Foreign-Body/therapy
- Granuloma, Giant Cell/diagnosis
- Granuloma, Giant Cell/etiology
- Granuloma, Giant Cell/immunology
- Granuloma, Giant Cell/therapy
- Humans
- Male
- Peritoneal Dialysis, Continuous Ambulatory/adverse effects
- Peritoneal Dialysis, Continuous Ambulatory/instrumentation
- Peritonitis/diagnosis
- Peritonitis/etiology
- Peritonitis/immunology
- Peritonitis/therapy
- Polycystic Kidney, Autosomal Dominant/diagnosis
- Polycystic Kidney, Autosomal Dominant/therapy
- Treatment Outcome
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Affiliation(s)
| | | | | | - Bilal Yildiz
- Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
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Antoniac I, Negrusoiu M, Mardare M, Socoliuc C, Zazgyva A, Niculescu M. Adverse local tissue reaction after 2 revision hip replacements for ceramic liner fracture: A case report. Medicine (Baltimore) 2017; 96:e6687. [PMID: 28489745 PMCID: PMC5428579 DOI: 10.1097/md.0000000000006687] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION In younger patients, ceramic-on-ceramic (CoC) bearing surfaces are usually recommended for total hip replacement (THR) because of their low wear rate and longer expected functional life. Although technical advancements have reduced the risk of ceramic bearings fracture, this complication remains a major concern. CASE DESCRIPTION We present the case of a 56-year-old patient undergoing 3 revision hip arthroplasties of the right hip due to ceramic liner fractures. Initial THR (2008) was performed with a CoC bearing, followed by liner fracture due to trauma a year later. The acetabular component and liner were replaced, with a minor incongruence between the old head and new insert. The 2nd ceramic insert fractured 3.5 years later, following minor trauma. Upon revision, the bearing surface was changed to metal-on-polyethylene (MoP). The performed retrieval analysis demonstrated stripe and rim wear, and evidence of adhesive wear. The patient was referred to us a month later, with a fistula on the lateral side of the hip, discharging black, petroleum-like liquid. Radiology showed well-fixed implants, no dislocation and no apparent polyethylene wear. Microbiological assessment of the discharge showed no infection. Intraoperatively massive metallosis was noticed, with stable acetabular and femoral components. The metal femoral head was heavily abraded, with almost 1% volumetric wear. Hematoxylin and eosin stained frozen tissue samples showed muscular and adipose tissue necrosis, while polarized light microscopy highlighted metal, polyethylene, and ceramic particles. CONCLUSION The present case is yet another report showing the adverse outcomes of using MoP bearings for revision after ceramic liner fracture in THR.
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Affiliation(s)
- Iulian Antoniac
- Biomaterials Group, Materials Science and Engineering Faculty, University Politehnica of Bucharest
| | - Mihai Negrusoiu
- Colentina Clinical Hospital, Clinic of Orthopaedics and Traumatology I, Bucharest
| | - Mihai Mardare
- Victor Babeş University of Medicine and Pharmacy, Timişoara
| | - Claudiu Socoliuc
- Department of Pathology, Colentina Clinical Hospital
- Department of Anatomical Pathology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest
| | - Ancuţa Zazgyva
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş
| | - Marius Niculescu
- Colentina Clinical Hospital, Clinic of Orthopaedics and Traumatology I, Bucharest
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
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Abstract
Diagnosis of tattoo complications is a multi-facetted field since many clinical entities and disease mechanisms are represented. Infections, allergies, and pigment foreign body reactions with granuloma are the major groups. The clinician needs a structured approach to diagnosis and an armamentarium of standard tests. Diagnosis primarily builds on patient history, objective clinical examination, and punch biopsy, supplemented with microbiology testing, ultrasound scanning, and clinical photography. Evaluation of allergic tattoo reactions and allergy to pigments by patch testing is not applicable and has a falsely negative outcome except for the diagnosis of allergy to metals and preservatives. Simple inspection of raw punch biopsies from chronic tattoo reactions, preferably evaluated with stereo microscopy, provides important information about the density and the local distribution of tattoo pigment in the dermis and changes of micro- anatomical skin structures. Histology may show subtle structural changes, but traditional patterns (lichenoid reaction, pseudolymphoma, granuloma, and pseudoepitheliomatous epidermal hyperplasia) are of little or no help in the diagnosis since the patterns overlap and have no distinct clinical correlates. Histology cannot separate allergic and nonallergic reactions. However, granulomatous reaction and sarcoid granuloma are significant findings since papulonodular reaction of black tattoos and sarcoidosis are strongly associated with each other. 20-MHz ultrasound scanning is important for noninvasive imaging and characterization of inflammatory tattoo reactions and can be used preoperatively as guide to treatment. Electron microscopy can visualize pigment particles in tissues, cells, and tattoo inks. Chemicals of pigment in tissues and in tattoo inks can be analyzed by high-performance liquid chromatography, mass spectroscopy, and Raman spectroscopy.
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Affiliation(s)
- Jørgen Serup
- The 'Tattoo Clinic', Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
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Abstract
With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented.
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Abstract
Tattoos, and tattoo complications as well, are colorful and visually flashy. A clinical outlook provides important clues to diagnosis by pattern recognition. This atlas,which is a report of 79 case illustrations, is made as a practical tool and vade mecum for the clinician. The atlas can be used in the office and as a bedside tool. It includes characteristic photos, and each case is accompanied with a brief medical history, a comment with learning points, the final diagnosis, and a review of therapeutic options. This spectrum of cases illustrates the different diagnostic entities according to the newly proposed Bispebjerg University Hospital ('Tattoo Clinic') diagnostic system of tattoo complications, a system reported to the 11th revision of the WHO disease classification system. Cases include allergies predominantly seen in red tattoos manifesting the characteristic patterns of plaque elevation, excessive hyperkeratosis, ulcerating reactions, urticaria, and generalized skin rash. Each type of reaction has typical clues to diagnosis and a typical disease course. 'Cross-sensitivity' allergic reactions in old tattoos of the same color as the trigger tattoo are also illustrated. Reactions in black tattoos are dominated by a pattern with papulonodular reactions, which are nonallergic anddue to pigment agglomeration in the skin. Reactions may be granulomatous and a marker of systemic sarcoidosis, sometimes associated with a general outbreak in the skin in black tattoos, e.g. 'rush phenomenon'. Bacterial infections are also illustrated. The technical hazards of tattooing and sequels as well as unwanted effects of tattoo removal by lasers are shown along with severe scarring following tattoo removal by caustics. This atlas is a tutorial in modern medical and surgical treatments of tattoo complications.
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Affiliation(s)
- Jørgen Serup
- The 'Tattoo Clinic', Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
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Hashimoto S, Yamasaki N, Doi R, Hatachi G, Kamohara R, Miyazaki T, Matsumoto K, Tsuchiya T, Hashisako M, Tabata K, Nagayasu T. [Granuloma by Foreign Body Reaction to the Stapler Used for Partial Resection of the Lung]. Kyobu Geka 2017; 70:187-190. [PMID: 28293004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 66-year-old woman underwent right lower lobectomy and partial resection of the middle lobe for Stage I A double lung cancer. Five years after the operation, a routine computed tomography (CT) scan showed a mass on the staple line at the middle lobe. The mass was enlarged on CT scan after 6 months. A definitive diagnosis could not be made by bronchoscopic examination and fluoro-2-deoxy-glucose(FDG)/positron emission tomography( PET)-CT showed FDG uptake in the mass( early phase:SUVmax=3.24, late phase:SUVmax=4.31). Local recurrence of lung cancer was not completely denied, and right middle lobectomy was performed. Histopathologically, the resected specimen revealed granuloma with foreign body reaction. We should keep in mind the possibility of granuloma as differential diagnosis of lung cancer when using stapler.
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Affiliation(s)
- Shintaro Hashimoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Martínez-Martínez A, García-Espinosa J. Non-absorbable suture granuloma mimicking a retroperitoneal metastatic implant in a patient with sigmoid neoplasm. Rev Esp Enferm Dig 2016; 108:579-580. [PMID: 27615018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The development of a foreign body granuloma from non-absorbable suture is a relatively uncommon condition, exceptional in the retroperitoneum of patients operated on for colorectal surgery. We report the case of a patient with a history of sigmoid neoplasm showing a retroperitoneal nodule on CT and high activity on PET, mimicking a tumor implant. Pathology found a foreign body granuloma. Foreign body granuloma from suture is a condition that may look identical to tumor relapse or metastatic disease on CT and PET scans, thus requiring pathology confirmation.
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Kim BS, Joo SH, Kim HC. Spilled gallstones mimicking a retroperitoneal sarcoma following laparoscopic cholecystectomy. World J Gastroenterol 2016; 22:4421-4426. [PMID: 27158213 PMCID: PMC4853702 DOI: 10.3748/wjg.v22.i17.4421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/21/2016] [Accepted: 02/22/2016] [Indexed: 02/06/2023] Open
Abstract
Laparoscopic cholecystectomy has become a standard treatment of symptomatic gallstone disease. Although spilled gallstones are considered harmless, unretrieved gallstones can result in intra-abdominal abscess. We report a case of abscess formation due to spilled gallstones after laparoscopic cholecystectomy mimicking a retroperitoneal sarcoma on radiologic imaging. A 59-year-old male with a surgical history of a laparoscopic cholecystectomy complicated by gallstones spillage presented with a 1 mo history of constant right-sided abdominal pain and tenderness. Computed tomography and magnetic resonance imaging demonstrated a retroperitoneal sarcoma at the sub-hepatic space. On open exploration a 5 cm × 5 cm retroperitoneal mass was excised. The mass contained purulent material and gallstones. Final pathology revealed abscess formation and foreign body granuloma. Vigilance concerning the possibility of lost gallstones during laparoscopic cholecystectomy is important. If possible, every spilled gallstone during surgery should be retrieved to prevent this rare complication.
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Gentileschi S, Servillo M, D'Ettorre M, Salgarello M. Abdominal Subcutaneous Mass After Laser-Assisted Lipolysis and Immediate Multiple Treatments with a Dual-Wavelength Laser, Vacuum and Massage Device. Aesthet Surg J 2016; 36:NP144-9. [PMID: 26647137 DOI: 10.1093/asj/sjv248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 11/14/2022] Open
Abstract
UNLABELLED Body contouring by means of minimally invasive procedures is a growing trend. Current approaches to body contouring often involve a combination of surgical techniques (eg, laser-assisted liposuction) and a series of noninvasive device-based treatments aimed at accelerating recovery and improving aesthetic outcomes. In this case study, we describe a 38-year-old woman who presented with an abdominal-wall mass that resembled a tumor when assessed with magnetic resonance imaging. Twenty-six months before presenting to our office, the patient had undergone laser lipolysis and a series of treatments with a device that delivered dual-wavelength laser energy and vacuum-assisted massage. To address the patient's concerns, we removed the mass and performed abdominal dermolipectomy. No postoperative complications occurred, and the patient was highly satisfied with the aesthetic outcome. The results of histologic studies indicated that the mass was pseudocystic and fluid-filled, surrounded by a fibrous capsule, and characterized as a foreign-body granuloma. Further analysis is warranted regarding the safety of laser lipolysis without aspiration combined with a device delivering dual-wavelength laser energy and vacuum-assisted massage. LEVEL OF EVIDENCE 5 Risk.
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Affiliation(s)
- Stefano Gentileschi
- From the Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli, Rome, Italy
| | - Maria Servillo
- From the Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli, Rome, Italy
| | - Marco D'Ettorre
- From the Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli, Rome, Italy
| | - Marzia Salgarello
- From the Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli, Rome, Italy
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Tammaro A, Toniolo C, Giulianelli V, Serafini M, Persechino S. Chemical research on red pigments after adverse reactions to tattoo. Eur Ann Allergy Clin Immunol 2016; 48:46-48. [PMID: 26934738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Currently, the incidence of tattooing is on the rise compared to the past, especially among adolescents, and it leads to the urgency of monitoring the security status of tattooing centers, as well as to inform people about the risks of tattoo practice. In our clinical experience, 20% of tattooed patients presented adverse reactions, like allergic contact dermatitis, psoriasis with Koebner's phenomena and granulomatous reactions, with the latter most prevalent and most often related to red pigment. Adverse reactions to tattoo pigments, especially the red one, are well known and described in literature. Great attention has to be focused on the pigments used, especially for the presence of new substances, often not well known. For this reason, we decided to perform a study on 12 samples of red tattoo ink, obtained by patients affected by different cutaneous reactions in the site of tattoo, to analyze their chemical composition.
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Affiliation(s)
- A Tammaro
- Dermatology Unit, NESMOS Department, S. Andrea Hospital, University of Rome "Sapienza", Italy. Phone: +39 06 3377 5907 Fax: +39 06 3377 5378 E-mail:
| | - C Toniolo
- Ambiental Biology Department, Umberto I Hospital, University of Rome "Sapienza", Italy
| | - V Giulianelli
- Dermatology Unit, NESMOS Department, S. Andrea Hospital, University of Rome "Sapienza", Italy
| | - M Serafini
- Ambiental Biology Department, Umberto I Hospital, University of Rome "Sapienza", Italy
| | - S Persechino
- Dermatology Unit, NESMOS Department, S. Andrea Hospital, University of Rome "Sapienza", Italy
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Tirico MC, Neto CF, Valente NYS, Nico MM. Sclerosing Lipogranuloma with Multiple Skin Lesions and Pulmonary Involvement, Secondary to a Factitious Disorder. Acta Derm Venereol 2016; 96:268-9. [PMID: 26315839 DOI: 10.2340/00015555-2229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lemoy MJM, Schouten AC, Canfield DR. Granuloma Due to Oxidized Regenerated Cellulose in an Aged Rhesus Macaque (Macaca mulatta). Comp Med 2016; 66:59-62. [PMID: 26884411 PMCID: PMC4752037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/27/2015] [Accepted: 08/05/2015] [Indexed: 06/05/2023]
Abstract
Bioabsorbable hemostatic agents such as oxidized regenerated cellulose are widely used to control intraoperative diffuse capillary bleeding. Compared with electrocautery or ligation, oxidized regenerated cellulose has the advantage of controlling bleeding without occluding the vessel lumen or causing thermal injuries to adjacent tissue. Although the manufacturer recommends removal of the material once hemostasis is achieved, oxidized regenerated cellulose is a bioabsorbable hemostatic agent and is often left in the surgical bed to prevent subsequent bleeding after surgical closure. However, noninvasive imaging techniques have revealed granulomatous foreign-body reactions that mimic infection or tumor recurrence. We present a case report of sterile peritonitis and granuloma formation secondary to the presence of oxidized regenerated cellulose after intestinal resection to excise a colonic adenocarcinoma in an aged rhesus macaque.
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Affiliation(s)
- Marie-Josee Mf Lemoy
- Department of Primate Medicine, California National Primate Research Center, University of California, Davis, California, USA.
| | - Angela Colagross Schouten
- Department of Primate Medicine, California National Primate Research Center, University of California, Davis, California, USA
| | - Don R Canfield
- Department of Pathology, California National Primate Research Center, University of California, Davis, California, USA
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Rzaev DA, Kulikova EV, Moysak GI, Voronina EI, Ageeva TA. Teflon granuloma after microvascular decompression of the trigeminal nerve root in a patient with recurrent trigeminal neuralgia. Zh Vopr Neirokhir Im N N Burdenko 2016; 80:78-83. [PMID: 27070261 DOI: 10.17116/neiro201680278-83] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The use of a Teflon implant for Jannetta surgery in patients with trigeminal neuralgia is complicated in rare cases by the development of a Teflon granuloma and can cause recurrent facial pain. The article presents a clinical case of a Teflon granuloma developed after microvascular decompression of the trigeminal nerve root, describes the surgical findings and histological picture, and analyzes the literature, causes of granuloma development, and recommendations for treatment of these patients.
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Affiliation(s)
- D A Rzaev
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | - E V Kulikova
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | - G I Moysak
- Federal Center of Neurosurgery, Novosibirsk, Russia; Novosibirsk State University, Novosibirsk, Russia
| | - E I Voronina
- Regional Center of High Medical Technologies, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
| | - T A Ageeva
- Regional Center of High Medical Technologies, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
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Kratzsch T, Stienen MN, Reck T, Hildebrandt G, Hoederath P. Catheter-tip Granulomas Associated with Intrathecal Drug Delivery--A Two-Center Experience Identifying 13 Cases. Pain Physician 2015; 18:E831-E840. [PMID: 26431137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Intrathecal (IT) drug therapy with implanted pumps is an effective treatment modality for chronic pain and/or spasticity, especially after non-invasive treatment has failed. Long-term use of intrathecal opioids may cause formation of inflammatory masses at the tip of intrathecal catheters, possibly leading to neurological deficits and/or catheter revision. OBJECTIVE We aimed to identify risk factors for catheter-tip granuloma (CG) formation. STUDY DESIGN Retrospective study. SETTING Tertiary Spine Centers in Germany and Switzerland. METHODS We retrospectively reviewed data at 2 Swiss centers (Kantonsspital St. Gallen, Swiss Paraplegic Centre Nottwil) between 01/1994 and 10/2013. Collected data were age at operation, gender, smoking status, previous spinal operations, spinal level of catheter-tip, clinical symptoms, catheter testing with contrast agent, applied drugs, drug concentration, as well as cumulative daily drug dosages. RESULTS Thirteen patients with a mean age of 52.6 years and CG formation after a mean of 6.9 years of follow-up were identified and compared to 54 patients of similar age and length of follow-up (48.6 years, P = 0.535; follow-up 5.3 years, P = 0.236) without CG. In the analysis of risk factors, catheter ending in the middle thoracic spine (Th4-8; 38.5 vs. 6.5%; P = 0.010), previous spinal surgery (75 vs. 41%; P = 0.051), and chronic pain as an underlying primary symptom for IT drug therapy (100 vs. 56%, P = 0.003) were associated with CG formation. IT drug therapy for spasticity appeared to be much less associated with CG formation (0 vs. 44%, P = .0003). As the symptomatology is closely related to the medical treatment applied, patients with CG were more likely to be treated with IT morphine (77 vs. 20%; P < 0.001), and as tendency with IT clonidine (54 vs. 26%; P = 0.092) and IT bupivacaine (46 vs. 20%; P = 0.077). Average in-pump morphine concentration (30.3 vs. 19.5 mg/mL; P = 0.05) as well as average daily dose of morphine (12.5 vs. 6.2 mg/d; P = 0.037) were significantly higher in the CG group. Smoking could not be identified as risk factor for CG formation. LIMITATIONS Limitations include the retrospective approach, the limited group size of granuloma patients, as well as missing data in the investigated patient groups. CONCLUSION Our patient cohort with CG differed in some features, of which some like catheter localization, choice, dosage, and the concentration of drugs are potentially modifiable. These results could contribute to the prevention of CG in the future.
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Affiliation(s)
- Tobias Kratzsch
- Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Martin N Stienen
- Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland; Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Tim Reck
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | - Gerhard Hildebrandt
- Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Petra Hoederath
- Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Lozano JA, Gabarró JP, Fuertes EM, Domínguez FE. [PENILE PARAFFINOMA: RECONSTRUCTIVE SURGERY WITH COLLAGEN MATRIX AND SKIN GRAFTS]. ARCH ESP UROL 2015; 68:571-572. [PMID: 26550645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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46
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Park HE, Kim HT, Lee CH, Bae JH. Delayed lipogranuloma of the cheek following autologous fat injection: report of 2 cases. Int J Clin Exp Pathol 2014; 7:6391-6394. [PMID: 25337297 PMCID: PMC4203268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 08/20/2014] [Indexed: 06/04/2023]
Abstract
We presented 2 cases of lipogranuloma of the cheek following autologous fat injection. Facial autologous fat injection for soft tissue augmentation is a frequently used technique in the field of plastic surgery. Although this procedure was thought to be a safe procedure without foreign body reactions, there had been several case reports on lipogranuloma following autologous fat injection, especially into the periorbital area. In our cases, we experienced delayed lipogranulomas of the cheek area and successfully treated them with perioral excision.
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Affiliation(s)
- Hee Eun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University Seoul, Korea
| | - Hee Tae Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University Seoul, Korea
| | - Cha Hee Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University Seoul, Korea
| | - Jung Ho Bae
- Department of Otorhinolaryngology-Head and Neck Surgery, Mokdong Hospital, School of Medicine, Ewha Womans University Seoul, Korea
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Kootiratrakarn T, Kimura Y, Matsunaga J, Tagami H. Delayed Development of Foreign Body Granuloma from an Implanted Permanent Cardiac Pacemaker. J Dermatol 2014; 31:460-3. [PMID: 15235184 DOI: 10.1111/j.1346-8138.2004.tb00532.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2003] [Accepted: 01/27/2004] [Indexed: 11/27/2022]
Abstract
We report a case of a late-developing cutaneous mass on the chest wall that proved to be non-specific mixed cell granuloma adjacent to the lead-electrode parts of a permanent cardiac-pacemaker that had been implanted in the left chest of an 81-year-old man 6 years previously. The lesion was treated by cardiac surgeons, whose management consisted of cutting only the intradermal part of the lead-electrodes followed by tissue curettage, leaving the other portion embedded in the subendocardium because its removal could cause serious complications. Dermatologists should be alert to such late complications of embedded permanent pacemakers. Their removal requires close cooperation with cardiac surgeons to avoid unexpected complications.
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Onesti MG, Fino P, Amorosi V, Piro F, Pedace D, Carella S, Latini C. A clinical case of cutaneous silica granuloma. GIORN ITAL DERMAT V 2014; 149:376-378. [PMID: 24819770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- M G Onesti
- Department of Plastic, Reconstructive and Esthetic Surgery, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy -
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Paupério GS, Matos P, Cordeiro CR, Antunes MJ. Post thyroidectomy gossypiboma. Rev Port Cir Cardiotorac Vasc 2014; 21:111-113. [PMID: 26182454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Gossypiboma is an unfrequent surgical complication wich consists in the presence of a mass of textile origin surrounded by a foreign body reaction. The authors present a clinical case of a left paratracheal gossypiboma, diagnosed during the follow-up of a patient submitted to a total thyroidectomy two years before for a papilary carcinoma.
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50
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Ramer N, Wadhwani C, Kim A, Hershman D. Histologic findings within peri-implant soft tissue in failed implants secondary to excess cement: report of two cases and review of literature. N Y State Dent J 2014; 80:43-46. [PMID: 24851393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A link has been established between peri-implant disease and excess cement extrusion in cement-retained implant restorations. The histologic findings of two patients with failed implants secondary to residual excess cement are reported here. If excess cement is detected early and adequately removed, resolution can occur in the majority of situations. Simple recommendations are proposed, with the intention of preventing further implant failures from residual excess cement.
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