Primary lipogranuloma of the forehead

Abstract

Lipogranuloma describes a uniform histologic reaction of adipose tissue to endogenous or exogenous lipids or oily materials.‘.’ In 1900, Gersuny3 injected liquid paraffin into the scrotum of a boy for cosmetic reconstruction following bilateral orchiectomy with satisfactory results. In contrast, Heidingsfeld4 reported facial deformities following subcutaneous injections of this material to reduce wrinkles. Since that time, intentional and accidental administration of a wide variety of foreign bodies, such as soft or liquid paraffin, mineral oils, grease or silicone, in subcutaneous tissue causing these histopathologic changes has been describede5-’ The term “sclerosing lipogranuloma” was first used in 1959 by Smetana and Bernhard’ to describe a granulomatous reaction of adipose tissue resulting from some inciting event (eg, trauma). In contrast to other authors, they believed that this kind of histopathologic reaction represents an inflammatory response to endogenous lipid degeneration. In this report, we present a case of a patient with primary lipogranuloma of the forehead, who had no history of trauma or subcutaneous injection of any foreign material. Diagnostic management, histopathologic findings, and the adequate therapeutic procedure are described and discussed with the relevant literature.