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A delayed teflonoma of the neck simulating a thyroid neoplasm
M Wassef1, J Achouche, J P Guichard
1Department of Pathology, Hôpital Lariboisière, Paris, France.
ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|November 1, 1994
Summary
A rare complication of vocal cord paralysis treatment using Teflon paste injections is a pseudotumoral granulomatous foreign body reaction. This reaction, termed a "teflonoma," can manifest years later as a thyroid nodule.
Area of Science:
- Otolaryngology
- Pathology
- Endocrinology
Background:
- Intracordal Teflon paste injection is used to treat unilateral vocal cord paralysis.
- Foreign body reactions to injected materials can occur.
- Teflon (polytetrafluoroethylene) is a synthetic material used in medical implants.
Observation:
- A patient developed a pseudotumor in the thyroid area three years after Teflon injection for vocal cord paralysis.
- The lesion presented as a cold thyroid nodule.
- Frozen section examination revealed a giant-cell foreign body granuloma with refringent particles.
Findings:
- The diagnosis of a 'teflonoma' was confirmed by histological and ultrastructural analysis.
- Intratissular Teflon particles were identified and compared with fresh Teflon paste under light microscopy.
- A significant delay was noted between the Teflon injection and the clinical presentation of the lesion.
Implications:
- This case highlights a rare but significant delayed complication of intracordal Teflon paste injection.
- Awareness of 'teflonoma' is crucial for accurate diagnosis in patients with a history of Teflon injection.
- Pathologists and clinicians should consider Teflon foreign body reaction in the differential diagnosis of thyroid nodules.