RESUMEN
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.
Asunto(s)
Circuncisión Masculina , Granuloma de Cuerpo Extraño , Procedimientos de Cirugía Plástica , Masculino , Humanos , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/cirugía , Colgajos Quirúrgicos , Pene/cirugía , Procedimientos de Cirugía Plástica/efectos adversos , Circuncisión Masculina/efectos adversosRESUMEN
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.
Asunto(s)
Granuloma de Cuerpo Extraño , Neoplasias Hepáticas , Neoplasias del Recto , Masculino , Humanos , Anciano , Granuloma de Cuerpo Extraño/diagnóstico , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/cirugía , Fuga Anastomótica , Tomografía Computarizada por Tomografía de Emisión de Positrones , Peritoneo/patología , Neoplasias del Recto/cirugía , Neoplasias del Recto/patología , Neoplasias Hepáticas/patologíaRESUMEN
ABSTRACT: In the field of plastic surgery, various filler types have been developed, which are widely used for cosmetic or reconstruction purposes. However, unregulated substances often injected by unlicensed practitioners may cause difficult-to-treat side effects, such as foreign body granulomas. Since the forehead is an exposed area and the lesions are likely extensive, complete surgical removal with inconspicuous scar can be difficult. In addition, pharmacological treatments, such as steroids, have only a temporary effect. The authors report successful cases of foreign body removal combined with subcutaneous forehead lift via a pretrichial approach for cosmetic satisfaction.Ten patients who had received illegal filler injections that resulted in chronic granulomas on the forehead were studied. The granulomas were confirmed using sonography, and simultaneous foreign body removal and subcutaneous forehead lifts using pretrichial incisions were planned. For the surgical method, the forehead flap was carefully elevated to a uniform thickness in the subcutaneous plane via a pretrichial incision, and the foreign body was removed, paying attention to the forehead contour and nerve damage; excess skin was excised from the top of the flap to tighten the remaining skin on the forehead.None of the patients developed complications, such as skin necrosis, infection, hematoma, or wound dehiscence, during the follow-up period. The functional and aesthetic outcomes were satisfactory in all the patients.The subcutaneous forehead lift via a pretrichial incision seems to facilitate foreign body removal and improve the forehead deformity by tightening the remaining skin.
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Frente , Granuloma de Cuerpo Extraño , Ritidoplastia , Frente/cirugía , Granuloma de Cuerpo Extraño/cirugía , Humanos , Ritidoplastia/métodos , Colgajos QuirúrgicosRESUMEN
Diatoms are photosynthetic algae with a siliceous exoskeleton. Diatoms are utilized by a wide array of industries for applications such as filtration and pest control. Unsubstantiated claims have also propelled their societal reach to trendy oral and topical uses. This case highlights a rare case of an oral granuloma secondary to diatoms. An 80-year-old woman presented with a mobile, firm, asymptomatic submucosal mass on her lower left mandibular vestibular mucosa. Histopathology showed a non-caseating granulomatous reaction to diatoms. Her only verified contact with a diatomaceous earth product was a dental impression using alginate after upper front teeth trauma 5 months before. Although there have been several cases of allergic contact dermatitis attributed to diatoms, there are no reported cases of diatom-induced granuloma formation found in the literature. There are, however, ample data on granulomas initiated by silica. Given the silica-based composition of diatoms, and the broad use of diatoms in industry and alternative medicine, it is unclear why diatom-induced granulomas are not more widely described. This report may alert clinicians to the existence of diatom granulomas and incline them to tailor their history to cover questions about possible exposure when evaluating patients presenting with a localized oral lesion.
Asunto(s)
Tierra de Diatomeas/efectos adversos , Granuloma de Cuerpo Extraño/diagnóstico , Mucosa Bucal/patología , Dióxido de Silicio/efectos adversos , Anciano de 80 o más Años , Biopsia , Coronas/efectos adversos , Diatomeas/ultraestructura , Femenino , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/patología , Granuloma de Cuerpo Extraño/cirugía , Humanos , Fitoplancton/ultraestructuraRESUMEN
BACKGROUND: Subcutaneous injection of illicit polymers can result in a number of local complications, including injection-site deformity, granulomas, and skin changes. OBJECTIVES: The aim of this study was to compare postoperative complications and symptom flare in patients undergoing surgical excision of foreign-body granulomas. METHODS: We retrospectively examined data of patients who underwent surgical removal of foreign-body granulomas caused by polymer injection for cosmetic purposes. The granulomas were removed by ultrasonic-assisted liposuction or en bloc excision with primary closure, skin grafts, or free flaps during 2014 to 2020. Data collected included demographic and operative parameters. Postoperative complications, symptom flare, and time to flare were reported. The relations between type of surgery and complications, symptom flare, and time to flare were determined through statistical analysis. RESULTS: The final cohort included 49 surgeries (42 primary and 7 secondary) in 35 patients. The overall complication rate was 28.9%, with no significant intergroup differences (30.8%, 20%, 66.7%, and 40%; Pâ =â 0.328). Wound dehiscence and skin burns were the main complications. An overall symptom flare of 35.1% in surgically treated areas over a mean period of 28.49 months was reported. Chi-squared test indicated statistical significance between type of surgery and symptom flare (Pâ =â 0.004) and between complications and flare (Pâ =â 0.013). Kaplan-Meier test for flare was statistically significant (Pâ =â 0.006) after comparison of the 4 groups. CONCLUSIONS: The rate of postoperative complications was similar for each type of surgery. However, en bloc excision and reconstruction by either primary closure or free flap was associated with a significantly decreased rate of symptom flare and a longer symptom-free period.
Asunto(s)
Granuloma de Cuerpo Extraño , Procedimientos de Cirugía Plástica , Granuloma de Cuerpo Extraño/diagnóstico , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/cirugía , Humanos , Polímeros , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Procedimientos de Cirugía Plástica/efectos adversos , Estudios RetrospectivosRESUMEN
Foreign body granulomas from sutures are more common among non-absorbable sutures compared to absorbable sutures and have been reported as a postoperative complication in a variety of medical fields. However, only a few cases of delayed foreign body reaction have been reported and addressed with orthopedics. We present a patient with systemic lupus erythematosus who developed an infectious suture granuloma that extended to the entire Achilles tendon and was induced by nonabsorbable sutures that were used for open Achilles tendon repair 20 years before. This granuloma was resistant to antibiotic treatment and drainage and required surgical intervention. The tumor was marginally resected, and the continuity of the Achilles tendon was preserved. Histopathological examination detected many suture materials surrounded by xanthochromic necrotic lesions and the lesion was diagnosed as a foreign body granuloma. At 1 year after the operation, the patient did not exhibit exacerbation of infection or recurrence of the tumor, and she became able to walk by herself. To the best of our knowledge, this represents the first report of an infectious delayed foreign body granuloma in autoimmune disorder patient after open Achilles tendon repair. Surgical intervention should be considered, as treatment with conservative therapy such as antibiotics may be difficult.
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Tendón Calcáneo , Granuloma de Cuerpo Extraño , Procedimientos de Cirugía Plástica , Tendón Calcáneo/cirugía , Femenino , Granuloma de Cuerpo Extraño/diagnóstico , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/cirugía , Humanos , Rotura/cirugía , Técnicas de Sutura , Suturas/efectos adversosRESUMEN
Cholesterol granuloma is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. Furthermore, a huge and aggressive cholesterol granuloma involving the maxillary sinus, hard palate, buccal space, and maxillary alveolus is extremely rare and has not been reported previously. This article reports a case of huge cholesterol granuloma in the maxillary sinus confused with an expansile odontogenic keratocyst, which was treated successfully via transnasal endoscopic approach.
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Granuloma de Cuerpo Extraño/cirugía , Seno Maxilar/cirugía , Quistes Odontogénicos/cirugía , Enfermedades de los Senos Paranasales/cirugía , Anciano de 80 o más Años , Colesterol , Femenino , Granuloma de Cuerpo Extraño/complicaciones , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Humanos , Seno Maxilar/diagnóstico por imagen , Boca , Neuroendoscopía , Quistes Odontogénicos/complicaciones , Quistes Odontogénicos/diagnóstico por imagen , Enfermedades de los Senos Paranasales/complicaciones , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Alveolo DentalRESUMEN
Cholesterol granuloma is a foreign-body giant cell reaction that can occur in response to the presence of cholesterol crystals. They are usually found in the middle ear, paranasal sinuses or mastoid process due to chronic inflammation. Presentation in the prevascular mediastinum is a rare finding. We describe a case of a cholesterol granuloma located in the prevascular mediastinum in a symptomatic 57-year-old male patient.
Asunto(s)
Colesterol , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Linfoma/diagnóstico , Mediastino , Timoma/diagnóstico , Neoplasias del Timo/diagnóstico , Diagnóstico Diferencial , Granuloma de Cuerpo Extraño/cirugía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The lips are essential part of the beauty and attractiveness of the human face. Lip augmentation has become an increasingly used method to improve appearance. Soft tissue fillers are the most commonly used tools. Permanent fillers, however, have been associated with unwanted side effects after lip augmentation. In the present article the present authors will focus on permanent fillers based on polymethylmethacrylate (PMMA). The present authors provide a short review on PMMA fillers and known associated adverse events. The present authors provide a critical review of treatment options. Illustrated by clinical cases The present authors report our preferred treatment of PMMA nodules on lips by intralesional neodymium:YAG laser and blunt suction cannula with or without minor surgery.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Rellenos Dérmicos/efectos adversos , Granuloma de Cuerpo Extraño/cirugía , Terapia por Láser/instrumentación , Láseres de Estado Sólido/uso terapéutico , Labio/cirugía , Polimetil Metacrilato/efectos adversos , Rellenos Dérmicos/administración & dosificación , Estética , Femenino , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/patología , Humanos , Terapia por Láser/efectos adversos , Láseres de Estado Sólido/efectos adversos , Labio/patología , Persona de Mediana Edad , Polimetil Metacrilato/administración & dosificación , Rejuvenecimiento , Factores de Riesgo , Succión , Resultado del TratamientoRESUMEN
Age-related changes in menopause women not only affect the physical appearance of the female external genitalia but also disrupt sexual functioning, for which many menopause women may require treatment to resolve these aesthetic problems or sexual dysfunction. Unfortunately, it is not infrequent that women seek non-medical solutions, including local injection of an unapproved agent into external genitalia, and it is extremely rare for it to be reported in literature. This case study reports on the experiences of treating two menopause women who had labial granuloma induced by local injection of paraffin.
Asunto(s)
Granuloma de Cuerpo Extraño/cirugía , Parafina , Vulva/cirugía , Femenino , Cuerpos Extraños/patología , Cuerpos Extraños/cirugía , Granuloma de Cuerpo Extraño/patología , Humanos , Inyecciones , Menopausia , Persona de Mediana Edad , Vulva/patologíaRESUMEN
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.
Asunto(s)
Blefaroplastia/efectos adversos , Rellenos Dérmicos/efectos adversos , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/patología , Biopsia con Aguja , Blefaroplastia/métodos , Estudios de Seguimiento , Granuloma de Cuerpo Extraño/cirugía , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Medición de Riesgo , Siliconas/efectos adversos , Resultado del TratamientoRESUMEN
Foreign-body granuloma formation following filler injections is most commonly seen with permanent fillers; these reactions can occur years following the injections and often require either an intralesional steroid injection or surgical excision. The authors present a case of a 75-year-old woman with a history of systemic sarcoidosis previously treated with numerous immunosuppressive medications who was examined for bilateral infraorbital nodules and swelling that were unresponsive to treatment. She underwent a bilateral anterior orbitotomy through a transconjunctival approach with mass excision. The histologic analysis was consistent with foreign-body granulomata juxtaposed to implantable material, specifically ArteFill, which was injected many years prior. There were no separate noncaseating granulomas to suggest sarcoidosis as the underlying etiology. It is important to consider prior filler injections in patients with sarcoidosis who present with subcutaneous nodules as this changes management and may prevent the need for more aggressive immunosuppressive treatment.
Asunto(s)
Colágeno/efectos adversos , Granuloma de Cuerpo Extraño/inducido químicamente , Polimetil Metacrilato/efectos adversos , Sarcoidosis/diagnóstico , Anciano , Colágeno/administración & dosificación , Diagnóstico Diferencial , Femenino , Granuloma de Cuerpo Extraño/diagnóstico , Granuloma de Cuerpo Extraño/cirugía , Humanos , Inyecciones Intralesiones , Procedimientos Quirúrgicos Oftalmológicos/métodos , Polimetil Metacrilato/administración & dosificación , Tomografía Computarizada por Rayos XRESUMEN
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.
Asunto(s)
Rellenos Dérmicos/efectos adversos , Enfermedades de los Párpados/etiología , Granuloma de Cuerpo Extraño/etiología , Ácido Hialurónico/efectos adversos , Enfermedades Orbitales/etiología , Biopsia , Enfermedades de los Párpados/diagnóstico por imagen , Enfermedades de los Párpados/cirugía , Femenino , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Granuloma de Cuerpo Extraño/cirugía , Humanos , Persona de Mediana Edad , Enfermedades Orbitales/diagnóstico por imagen , Enfermedades Orbitales/cirugía , Tomografía Computarizada por Rayos XRESUMEN
The purpose of this study was to present our series of patients with disastrous consequences of failed penile self-augmentation and suggested surgical reconstruction. Ten patients with median age of 23 years and a variety of penile and scrotal deformities due to injections of several substances had undergone successful surgical reconstruction of external genitalia. The injections were self-performed in nine cases and the patients reported from 4 to 20 substance injections throughout the penile shaft. Three patients presented with fibrotic scirrhous masses in their scrotum, although they did not report any injections in scrotal area. All patients underwent extended penile-shaft skin excision, while all palpable scrotal lesions were removed in one-by-one fashion, as an attempt to destroy the less possible scrotal tissue. All patients were discharged on first post-operative day and reassessed at 2 months post-operatively. As a result, penile self-augmentation with injected substances may cause severe complications. Our proposed single-staged procedure seems safe and effective.
Asunto(s)
Disfunción Eréctil/cirugía , Granuloma de Cuerpo Extraño/cirugía , Enfermedades del Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Adulto , Disfunción Eréctil/etiología , Granuloma de Cuerpo Extraño/etiología , Humanos , Inyecciones Subcutáneas/efectos adversos , Masculino , Aceites/administración & dosificación , Aceites/efectos adversos , Aceite de Oliva/administración & dosificación , Aceite de Oliva/efectos adversos , Tamaño de los Órganos , Parafina/administración & dosificación , Parafina/efectos adversos , Enfermedades del Pene/etiología , Pene/anatomía & histología , Pene/patología , Pene/cirugía , Vaselina/administración & dosificación , Vaselina/efectos adversos , Escroto/patología , Escroto/cirugía , Siliconas/administración & dosificación , Siliconas/efectos adversos , Resultado del Tratamiento , Adulto JovenAsunto(s)
Granuloma de Cuerpo Extraño , Pterigion , Humanos , Pterigion/diagnóstico , Pterigion/cirugía , Poliglactina 910 , Granuloma de Cuerpo Extraño/cirugía , Conjuntiva/cirugía , Suturas/efectos adversos , Estudios de Seguimiento , Recurrencia , Resultado del Tratamiento , Técnicas de Sutura , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugíaAsunto(s)
Colesterol , Enfermedades del Nervio Facial/etiología , Parálisis Facial/etiología , Granuloma de Cuerpo Extraño/complicaciones , Síndromes de Compresión Nerviosa/etiología , Hueso Petroso/diagnóstico por imagen , Adulto , Enfermedades del Nervio Facial/diagnóstico por imagen , Enfermedades del Nervio Facial/cirugía , Femenino , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Granuloma de Cuerpo Extraño/cirugía , Humanos , Imagen por Resonancia Magnética , Síndromes de Compresión Nerviosa/diagnóstico por imagen , Síndromes de Compresión Nerviosa/cirugía , Hueso Petroso/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Teflon has been commonly used as a surgical material. In particular, Teflon has been considered suitable for microvascular decompression of cranial nerves, as it is a stable, inert substance that does not resorb or migrate. Giant cell foreign body reactions after microvascular decompression (MVD) have been reported, but this rare complication has not been well recognized. Here, we report one case of Teflon granuloma that occurred 4 years after MVD for hemifacial spasm. We discuss the cause, histopathological analysis, particular MVD surgical methods, and management of Teflon granuloma.
Asunto(s)
Granuloma de Cuerpo Extraño/patología , Granuloma de Cuerpo Extraño/cirugía , Espasmo Hemifacial/etiología , Espasmo Hemifacial/cirugía , Cirugía para Descompresión Microvascular/efectos adversos , Politetrafluoroetileno/efectos adversos , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/cirugía , Parálisis Facial/etiología , Parálisis Facial/patología , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/cirugía , Granuloma de Células Gigantes/patología , Granuloma de Células Gigantes/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Cholesterol granuloma (CG) is the most common benign lesion of the petrous apex, however, it can grow significantly large and become destructive causing a diagnostic dilemma. This case presents a 25-year-old female with 2-year history of left-sided progressive and profound hearing loss, a transient left-sided facial paralysis and cranial nerve 10 palsy who presented with a blue middle ear mass. Her diagnosis did not become apparent until direct visualization intraoperatively. The objective of this case study is to highlight the destructive capabilities of CG and the importance to keep it in the differential diagnosis of a large, erosive, expansile skull base lesion in order to avoid overly aggressive resection or other unnecessary treatment.