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Giant PMMA Foreign Body Granulomas with Imaging.
Sunthosh Sivam1, Christine Mackay2, Clinton Humphrey2
1Baylor College of Medicine, Houston, TX, USA.
Giant foreign body granulomas, a rare complication of polymethylmethacrylate (PMMA) filler, can develop years later. Intralesional injections of triamcinolone acetonide and 5-fluorouracil effectively treated this delayed filler complication.
Area of Science:
- Dermatology
- Plastic Surgery
- Radiology
Background:
- Filler complications encompass diverse presentations, with foreign body granulomas representing a rare late manifestation.
- Polymethylmethacrylate (PMMA) is a dermal filler known for its longevity and potential for delayed adverse reactions.
Observation:
- A case of giant foreign body granulomas emerged 7 years post-PMMA injection.
- Magnetic resonance imaging (MRI) provided unique pre- and post-treatment visualization of granuloma expansion and therapeutic response.
Findings:
- Intralesional triamcinolone acetonide and 5-fluorouracil demonstrated excellent efficacy in resolving the giant foreign body granulomas.
- The treatment resulted in significant reduction of granuloma size and associated inflammatory changes.
Implications:
- This case highlights effective management strategies for rare, late-onset filler complications.
- Non-surgical intralesional therapies are recommended as first-line treatments, reserving surgical excision for refractory cases.
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