Body dysmorphic disorders can be often diagnosed among the group of patients seeking plastic surgery with excessiveness. For the correction of unrealistic body images tied up in their minds, they have a tendency to choose improper plastic operation or unlicensed procedures rather than the psychiatric intervention. So- called 'illegal injection' performed by the unlicensed has been readily accessible tempting alternatives, which could result in disastrous outcomes due to multiple compulsive injections. Nowadays injection of foreign materials, such as paraffin oil or liquid silicon, is thought to be obsolete in modern medical procedures. Nevertheless, these illegal procedures have been in extensive use among some Asian countries, including Korea, by the unlicensed. Local complication, particularly, granulomatous inflammatory responses of variable severity can occur, despite skillful techniques and even small amount of injection. Futhermore, these lesions frequently persist or recur after treatment. We have a case of a body dysmorphic disorder manifesting severe, huge foreign body granulomas caused by silicon, paraffin and oil injected. Our case was a 38- years-old woman who had multiple huge masses on head and neck which had slowly grown after multiple injections for about 16 years. After a psychiatric intervention, we performed partial resection of masses in cheek and neck area, followed by liposuction of forehead, neck and scalp. A brief history of case and the clinical significance of foreign body injection in body dysmorphic disorder were described.
Asian Continental Ancestry Group ; Body Dysmorphic Disorders* ; Body Image ; Cheek ; Female ; Forehead ; Foreign Bodies* ; Granuloma ; Granuloma, Foreign-Body ; Head ; Humans ; Korea ; Lipectomy ; Neck ; Paraffin ; Scalp ; Silicones ; Surgery, Plastic

To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cases of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cases of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and bloody otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Temporal bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well-developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases, enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplasty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological etiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location, extension and severity of the lesion. The purpose of surgery is to remove the lesion and create an adequate drainage.
Cholesteatoma, Middle Ear/*complications ; Cholesteatoma, Middle Ear/diagnosis ; Cholesteatoma, Middle Ear/surgery ; *Cholesterol ; Granuloma, Foreign-Body/*complications ; Granuloma, Foreign-Body/diagnosis ; Granuloma, Foreign-Body/surgery ; Otitis Media/diagnosis ; Otitis Media/*etiology ; Retrospective Studies

Augmentation of the body contour by localized injection of hard and soft paraffin rose to a zenith of popularity in the early 1900s, whereafter the severe destructive consequences of such injections became widely recognized. However in Korea, these injections are still performed much by nonmedical person. Paraffin or other mineral oil injection into body is no more a useful method to change body contour. We reviewed 26 cases of sclerosing lipogranuloma of penis with complications in recent 13 years after mean 18.5 months from previous injection of paraffin or vaseline. We conclude that the public should be informed of detrimental effects of paraffin injections and that the best treatment of penile paraffinoma is complete excision and appropriate penoplasty.
Adult ; Aged ; Granuloma, Foreign-Body/*pathology/surgery ; Human ; Male ; Middle Age ; Paraffin/*adverse effects ; Penile Diseases/*pathology/surgery ; Sclerosis

In this report, we present two cases of bronchial foreign body granulomas caused by the suture ties used in bronchial surgery for esophageal cancer. Both of them was hospitalized as "tumor transfer or an invasion", but pathological examination of the neoplasms indicated an inflammatory granuloma showing reaction to the foreign body. These two cases give us an attention that the neoplasms in tracheal or bronchial was not only the invasion or transfer of the primary tumor, but also the possibility of granuloma development due to the surgical sutures.
Bronchial Neoplasms ; etiology ; Esophageal Neoplasms ; surgery ; Granuloma, Foreign-Body ; etiology ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Sutures ; adverse effects

Silicone has become one of the most commonly used biomaterials in modern medicine. There are three forms of silicone in medical use: silicone oil, gel, and rubber. Among these, silicone rubbers are used as heart valves, shunts, coatings on pacemakers and implants of cosmetic surgery. In tissues, silicone produces a range of histological reactions depending on the form of silicone. We report a case of a foreign body granuloma due to the prescence of silicone rubber inserted for nasal augmentation fifteen years previously, and review the complications of augmentation rhinoplasty using silicone implants.
Biocompatible Materials ; Foreign Bodies ; Granuloma, Foreign-Body ; Heart Valves ; History, Modern 1601- ; Rhinoplasty ; Rubber ; Silicone Elastomers ; Silicone Oils ; Skin ; Surgery, Plastic

BACKGROUND: Facial fat grafting is a common cosmetic surgery for facial contouring. Although it is considered a very safe procedure, there are several reports about complications after fat grafting. Eye complications are very rare, but do exist. The author has treated cases of eyelid swelling after forehead fat grafting with conservative or surgical treatment. METHODS: From February 2010 to April 2014, the author treated five women (mean age, 35 years; range 28-52), who developed eyelid swelling (both, n=3; unilateral, n=2) approximately 2 weeks after forehead fat grafting. Symptoms included pain, foreign body sensation, recurrent swelling and redness, unilateral or bilateral ptosis, and palpable lumps. Three were acute cases treated within 1 month, and the other two were chronic cases, which occurred 4 and 28 months after the fat graft. RESULTS: Conservative treatment (Lasix, antibiotics, steroids) was used for two patients. The other three patients were treated with direct fat extraction or lump excision through the double eyelid crease line. Histological examination identified the excised specimens as lipocysts or liopogranulomas. All patients fully recovered, despite transient ptosis for several days immediately after the operation. CONCLUSIONS: Eyelid swelling after forehead fat graft can be successfully treated with either conservative or surgical treatment. Although few studies have reported eyelid swelling after fat grafting, this complication may become more common, in the future, as facial fat grafting becomes more popular. This treatment modality should be helpful to the plastic surgeons faced with these unpleasant complications.
Anti-Bacterial Agents ; Eyelids ; Fat Necrosis ; Female ; Forehead* ; Foreign Bodies ; Granuloma, Foreign-Body ; Humans ; Postoperative Complications ; Sensation ; Surgery, Plastic ; Transplantation ; Transplants*

Cholesterol granuloma of the breast is a rare, benign disease. Here, we present the unique ultrasonographic findings of breast cholesterol granuloma manifesting as an intracystic mass. The findings of this case report may help expand existing knowledge regarding differential diagnosis of intracystic breast masses, which are found on ultrasonographic examination.
Biopsy, Needle ; Breast Diseases/pathology/surgery/*ultrasonography ; *Cholesterol ; Diagnosis, Differential ; Female ; Granuloma, Foreign-Body/pathology/surgery/*ultrasonography ; Humans ; Mammography ; Middle Aged ; *Ultrasonography, Mammary

To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cases of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cases of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and bloody otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Temporal bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well-developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases, enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplasty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological etiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location, extension and severity of the lesion. The purpose of surgery is to remove the lesion and create an adequate drainage.
Adolescent ; Adult ; Cholesteatoma, Middle Ear ; complications ; diagnosis ; surgery ; Cholesterol ; Female ; Granuloma, Foreign-Body ; complications ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Otitis Media ; diagnosis ; etiology ; Retrospective Studies

Cholesterol granuloma is a histological term used for the description of a tissue response to a foreign body such as cholesterol crystals. Cholesterol granuloma is histologically characterized as fibrous granulation tissue containing cholesterol crystals within surrounding giant cells. Cases of cholesterol granuloma of the pancreas are very rare. We report a case of a 47-year old male who had a cholesterol granuloma of the pancreas. Abdominal CT showed 24 mm-sized cyst in the pancreas and peri-pancreatic regional mass infiltrating to the stomach. PET-CT revealed increased 18F-FDG uptake at the cyst and peri-pancreatic mass. Thus, Whipple's operation was done. The disease was confirmed by surgical pathologic examination of the tissue. Pathologic examination of resected specimen showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells. We report on this case and give a brief review of the literature.
*Cholesterol ; Diagnosis, Differential ; Fluorodeoxyglucose F18/chemistry/diagnostic use ; Granuloma, Foreign-Body/*pathology/radionuclide imaging/surgery ; Humans ; Male ; Middle Aged ; Pancreas/pathology ; Positron-Emission Tomography ; Tomography, X-Ray Computed

We report a case of intracranial foreign body granuloma that showed features of a high grade tumor on magnetic resonance (MR) imaging. However, the relative cerebral blood volume was not increased in the enhancing mass on perfusion MRI and the choline/creatine ratio only slightly increased on MR spectroscopy. The results suggest that the lesion is benign in nature. Perfusion MRI and MR spectroscopy may be helpful to differentiate a foreign body granuloma from a neoplastic condition.
Adult ; Blood Volume ; Brain/*pathology/surgery ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Echo-Planar Imaging/*methods ; Female ; Follow-Up Studies ; Gadolinium/diagnostic use ; Granuloma, Foreign-Body/*pathology/surgery ; Humans ; Image Enhancement/methods ; Magnetic Resonance Angiography/*methods ; Magnetic Resonance Spectroscopy/*methods