Lipogranuloma of the Face Associated with a Traumatic Event: a Case Report

Abstract

Lipogranuloma, an inflammatory reaction of granulomatous soft tissue, consists of lipid and/or oil-like deposits commonly associated with injections or trauma, or secondary to systemic diseases. A 64-year old woman presented with painful, hardened facial nodules and lip swelling since 7 months prior, which was refractory to antibiotic therapy; domestic violence was reported as the causative factor. A diagnostic hypothesis of Melkersson-Rosenthal syndrome had been rendered at another service. Intraorally, she presented with a fissured tongue, tooth decays, periodontal disease, and xerostomia and extraorally with lower lip and right medial face edema. Magnetic resonance imaging showed an elongated lesion in the region of the right face and diffuse swelling of the lower lip, without adjacent invasion. Biopsy revealed histologic evidence of a granulomatous soft tissue reaction consistent with lipogranuloma. The clinical finding of lipogranuloma that is probably secondary to endogenous inflammatory lipid degeneration after trauma is rare.