@article{2991692,
    title = "Granulomatous Foreign-Body Reaction Involving Oral and Perioral Tissues After Injection of Biomaterials: A Series of 7 Cases and Review of the Literature",
    author = "Jham, B.C. and Nikitakis, N.G. and Scheper, M.A. and Papadimitriou, J.C. and Levy, B.A. and Rivera, H.",
    journal = "Asian Journal of Oral and Maxillofacial Surgery",
    year = "2009",
    volume = "67",
    number = "2",
    pages = "280-285",
    issn = "0915-6992",
    doi = "10.1016/j.joms.2008.01.052",
    keywords = "biomaterial;  CD68 antigen, adult;  aged;  article;  cheek mucosa;  clinical article;  controlled study;  cytoplasm;  female;  foreign body granuloma;  histiocyte;  histopathology;  human;  immunohistochemistry;  lower lip;  medical literature;  mouth;  soft tissue;  upper lip, Adult;  Aged;  Biocompatible Materials;  Biopolymers;  Body Modification, Non-Therapeutic;  Collagen;  Cosmetic Techniques;  Diagnosis, Differential;  Female;  Granuloma, Foreign-Body;  Humans;  Injections;  Lip;  Lip Neoplasms;  Lipoma;  Middle Aged;  Mouth Mucosa;  Tissue Expansion",
    abstract = "Purpose: Injectable implants used for soft-tissue augmentation may lead to a granulomatous foreign-body reaction. The aim of this report is to present 7 new cases of foreign-body granulomas involving the oral and perioral tissues, after injection of biomaterials to achieve soft-tissue augmentation. In addition, the clinical and epidemiological profile of this condition is summarized, based on a review of the English-language literature of all previously described cases. Patients and Methods: We report on 7 new cases of granulomatous foreign-body reaction involving the oral and perioral tissues after the injection of biomaterials. A comprehensive literature review is also presented. Results: The literature search revealed 49 cases of this condition affecting the oral and perioral tissues. Our 7 patients were female, with a mean age of 52.8 years (range, 34 to 70 years). The lower lip was affected in 4 cases, 1 case was located in the upper lip, 1 case in the buccal mucosa, while 1 case involved 2 different sites (upper lip and buccal mucosa). Histopathologic examination revealed numerous cells with clear, often multiple, cytoplasmic vacuoles, bearing a resemblance to lipoblasts. Immunohistochemistry revealed diffuse positivity for the histiocytic marker CD68. Conclusions: The diagnosis of granulomatous foreign-body reactions may be challenging because of their microscopic resemblance to liposarcoma, and because of the occasional reluctance of patients to report the previously performed esthetic procedure. A clinical history, histopathologic examination, and immunohistochemical analysis (as needed) are essential in achieving an accurate diagnosis. © 2009 American Association of Oral and Maxillofacial Surgeons."
}