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.
Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, United States of America.
Am J Otolaryngol. 2019 Sep-Oct;40(5):776-778. doi: 10.1016/j.amjoto.2019.05.010. Epub 2019 May 14.
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.
异物肉芽肿即使在自体脂肪或填充物注射后数年也可能发生。在某些情况下，异物肉芽肿已经在原始注射部位以外的部位被发现。我们报告了一例 48 岁男性，据报告在几年前在上眼睑和下眼睑注射了“透明质酸填充物”。随后，他出现眶周肿胀，过敏和风湿免疫检查均为阴性。患者最终接受了眼睑成形术以改善肿胀。组织病理学提示上眼睑和下眼睑有硅酮肉芽肿。该病例说明了对于所有有面部真皮填充物注射史的患者，异物肉芽肿均应作为鉴别诊断的重要内容。尽管透明质酸是最常见的真皮填充物，但提供者应怀疑使用其他真皮填充物，包括未经 FDA 批准的填充物，特别是当常见的保守治疗方法不足时。
