[Midline granuloma. A review of the literature with particular reference to diagnostic and therapeutic problems supplemented by 3 personal case reports].

The term midline granuloma and various synonyms have been used to describe a rare lesion that ultimately forms a necrotizing ulcerating destruction of the midface. The aetiology has been variously and repeatedly discussed, and a review of the literature shows that at least three entities, which are difficult to differentiate, should be considered. Wegener's granulomatosis, malignant lymphoma and atypical histiocytic lymphoma, a disease with a pleomorphic histology, may all have an extensive necrosis and an intense inflammatory reaction. Upon the diagnosis, which is confirmed by biopsy, depends the appropriate treatment of these fatal diseases. The collective term midline granuloma should be avoided since it may delay the correct management.