18 F-FDG PET/CT Findings in a Young Man With Fatal Complications From Self-administered Paraffin Injections

Area of Science:

• Radiology and Nuclear Medicine
• Pathology
• Dermatology

Background:

• Paraffin injections are sometimes used for cosmetic enhancement.
• Complications from illicit or self-administered injections can be severe and widespread.
• Imaging plays a crucial role in diagnosing complications from foreign body injections.

Purpose of the Study:

• To report a case of extensive complications from self-administered paraffin injections.
• To illustrate the imaging findings of paraffinoma and associated complications using [18F]FDG PET/CT.
• To highlight the potential systemic effects of cosmetic paraffin injections.

Main Methods:

• A 34-year-old male patient with a history of self-administered paraffin injections underwent [18F]FDG PET/CT imaging.
• Radiological analysis of the PET/CT scan was performed to identify abnormalities.
• Clinical history and imaging findings were correlated.

Main Results:

• [18F]FDG PET/CT revealed disseminated hypodense granulomas (oil deposits) in the upper extremities and chest musculature.
• Extensive calcifications were observed throughout the body, affecting muscles, subcutaneous tissues, scrotum, kidneys (nephrolithiasis), and vascular walls.
• The findings indicate a systemic inflammatory and foreign body reaction to injected paraffin.

Conclusions:

• Self-administration of paraffin for esthetic purposes can lead to severe, disseminated complications including granulomas and extensive calcifications.
• Paraffinoma and associated calcific changes can affect multiple organ systems, as demonstrated by [18F]FDG PET/CT.
• This case underscores the risks associated with non-medical grade injections and the utility of advanced imaging in diagnosis.