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Sclerosing lipogranuloma (SLG) in children is a rare, benign disease of unknown etiology suspected to be due to abnormal fatty tissue reaction. A 13-year-old girl presented with progressively worsening back pain. Cross-sectional imaging identified a retroperitoneal mass compressing the left ureter as well as infrarenal inferior vena cava atresia with extensive venous collaterals and chronic partially occlusive thromboses of the iliac veins. Surgical biopsy was consistent with SLG and it resolved spontaneously. SLG is typically a disease of adulthood but may be seen in children. The association between inferior vena cava atresia with venous thrombosis and development of SLG has not been reported previously.

The use of vitamin E for Facial rejuvenation is a dangerous practice and is associated with potential local, and sometimes systemic and life-threatening complications. Clinicians should be aware of complications induced by the injection of illegal products for tissue augmentation. Also, regulatory organizations should monitor illegal beauty centers and enact restrictive laws.Herein, we report a case of liquid vitamin E injection for cosmetic facial rejuvenation and development of facial persistent erythema and induration, treated with oral prednisolone, azathioprine, and minocycline. Also, we review the reported cases of vitamin E injection for cosmetic facial rejuvenation.Lipogranuloma is one of those complications of vitamin E injection for cosmetic rejuvenation. It mostly represents inflammation, edema, erythema, and tenderness. Since there was no standard treatment for this complication, the management of these patients is challenging. Patients who have undergone cosmetic interventions in illegal institutions are more likely to develop such complications including medical and psychological problems. Clinicians should be aware of these complications for the best diagnosis and treatment.

Objective: To investigate the clinical features of patients who develop periorbital lipogranuloma after injection of autologous fat. Methods: This retrospective case series included 18 patients who developed a periorbital mass or swelling after undergoing injection of autologous fat for facial augmentation. The patients’ medical records were reviewed for clinical history, radiologic findings, and treatment outcomes. Results: All patients were women aged 24 to 50 years (mean, 31.6 years). Five patients (27.8%) involved both orbits. Presenting eye symptoms were a palpable mass (61.1%), eyelid swelling (44.4%), and ptosis (16.7%). The interval between the final injection and onset of eye symptoms ranged from 1 to 36 months (mean, 11.5 months). Thirteen patients underwent radiologic imaging. Fifteen patients received only one injection of autologous fat and three received two injections with the cryopreserved fat used in the second injection. Surgical excision was performed in 12 patients to remove the mass and identify the pathologic abnormalities. No recurrence was found during 1 year of follow-up. Two of the six patients who had refused treatment showed spontaneous resolution at the 6-month visit. Conclusion: Periorbital lipogranuloma after facial injection of autologous fat should be considered as a specific orbital disease entity for which MRI is an effective examination method. Surgery is warranted for this condition when conservative treatment is ineffective.

Objective Lipogranuloma is a rare inflammatory reactive process in the dermis and subcutis. We present a summary of the 6 cases of lipogranuloma after facial cosmetic procedures. Study Design We performed a retrospective review including patient demographic data, clinical symptoms, appearance on computed tomography, treatment, pathology results, and history of facial cosmetic procedures. Results In most cases, the nodules were painless and showed no significant growth. Computed tomography revealed ill-defined swellings in the buccal fat pad with heterogeneous density. Histopathological examinations revealed numerous variable-sized empty microcysts surrounded by abundant lymphocytes and foamy macrophages, the characteristic features of lipogranuloma. On further questioning, all of the patients revealed that they had undergone some form of facial cosmetic procedure in the preceding months to years. Among the 6 cases, facial autologous fat injection may have been the main cause of lipogranuloma. Conclusion Lipogranulomas can develop months to years after facial cosmetic procedures distant from the injection sites. A thorough understanding of the patient's medical history and the clinical and histopathologic characteristics of lipogranuloma are necessary to make a definite diagnosis and allow appropriate treatment.

Ten years ago, a 57-year-old man fell into a full oilcan, penetrating the straight spout suborbital into the right frontal lobe (figure, A). Two years later, he developed symptomatic epilepsy. A cranial MRI showed extensive edema formation (figure, B) and pathologic contrast enhancement (figure, C). In a neurosurgical biopsy, multiple granulomas around small oil droplets appeared. Histopathologic analysis revealed a chronic meningoencephalitis with granulomas and giant cells congruent with a foreign body reaction (figure, D–F).

We introduce a new modified penile skin reconstruction technique to treat paraffin-induced sclerosing lipogranuloma of the penis.From 2017 to 2020, 49 patients underwent the procedure. Complete removal of the lipogranuloma-involved penile skin was performed. A subcutaneous tunnel was then created between a horizontal scrotal incision and a proximal penile circumferential incision. The denuded penis was pulled through the tunnel, and a subcoronal and longitudinal dorsal penile suture line was made. An inverted V-shaped incision was made on the scrotum on the ventral side of the penis, followed by longitudinal closure. Outcomes and complications of the procedure were retrospectively studied. The long-term effect of surgery on sexual function and overall satisfaction was measured using a patient-reported questionnaire, which was completed by 30 patients.The overall complication rate was 26.5%. Clavien-Dindo grade 1, 2, 3a, 3b, 4 and 5 complications occurred in the postoperative period 5, 0, 8, 1, 0 and 0 times, respectively, in 13 patients. Surgery was successful in 27 (90%) patients according to the patient-reported questionnaire. Erectile dysfunction, pain/tension during erection, premature ejaculation and penile lymphedema were observed in 2, 3, 1 and 1 patients, respectively. All patients reported sexual intercourse ability.The type of penile skin reconstruction after the removal of sclerosing lipogranuloma of the penis is controversial. The reconstruction technique presented herein is an effective single-stage treatment option with a high success rate in patients with sclerosing lipogranuloma of the penis with intact scrotal skin.

Penile self-injections are performed with the purpose of increasing the size of the penis. Commonly, mineral oils or mineral oil-like substances are used for this purpose. However, there are very few publications describing on the complications from vegetable oil injections especially olive oil. Following the injection, the resulting deformity of the male genitalia is described as penile paraffinomas lipogranuloma of the penis. We would like to report a case of penis augmentation by a 50-year-old gentleman using olive oil injections that caused a massive, severely deformed of the penis and scrotum. Surgical excision and reconstruction was done. The patient was discharged after five days postoperatively, with full graft take. Injecting any oily substances into the human body is hazardous. The differential diagnosis of nodules following injections should be kept in mind and in doubtful cases, biopsy should be done. Regular follow-up is essential to prevent the further inflammatory event. Safe and legal procedures should be implemented for penile enlargement so as to avoid self-injections and in the prevention of such debilitating problems.

Összefoglaló. Bevezetés: A hímtag körméretének növelése érdekében, az annak bőre alá bejuttatott zsírnemű anyag szklerotizáló lipogranulomát okoz. Hazánkban a szklerotizáló lipogranuloma okozta hímvessző-deformitások kezelésének legelterjedtebb módszere a két ülésben végzett bőrpótlás. Ennek ellenére a magyar nyelvű szakirodalomban kevés adat áll rendelkezésre a kétüléses műtét eredményességéről és várható szövődményeiről. Célkitűzés: Tanulmányunkban a szklerotizáló lipogranuloma okozta deformitások miatti - két ülésben végzett - hímvesszőbőr-helyreállítással szerzett tapasztalatainkról, a műtét után kialakuló szövődményekről számolunk be retrospektív adatgyűjtés alapján. Módszer: 2008. március 1. és 2020. március 1. között a Debreceni Egyetem Urológiai Klinikáján 17 betegen végeztünk kétüléses hímvesszőbőr-helyreállító műtétet. A szklerotizáló lipogranuloma által érintett bőrt teljes mértékben eltávolítottuk, majd a lecsupaszított hímtagot a herezacskó elülső felszínén kialakított subcutan csatornába helyeztük. A második ülés során a herezacskó bőre alá ültetett hímvesszőt felszabadítottuk. Eredmények: A Clavien-Dindo-beosztás szerint az első ülés után három, a második ülés után egy I. gradusú szövődmény alakult ki; II-V. gradusú szövődményt nem figyeltünk meg. Azon 9 beteg közül, akik mindkét ülésen átestek, 7 beteg elégedett volt a beavatkozás eredményével, 2 beteg korrekciós műtéten esett át fél és 9 évvel a második ülés után. A 8 beteg közül, akik csak ez első ülést vállalták, egy korrekciós műtét történt 4 hónappal a műtét után. Következtetés: A hímvessző szklerotizáló lipogranulomája esetén az érintett bőrterület kimetszése után hímvesszőbőr-helyreállítás szükséges. A herezacskó-bőrlebeny alkalmazásának előnye, hogy a herezacskó színe és elaszticitása a hímvesszőbőréhez hasonló, a tapintás- és erogén érzet megmarad. A kétüléses hímvesszőbőr-helyreállítás kevés szövődménnyel, plasztikai sebészeti jártasság nélkül elvégezhető. Orv Hetil. 2021; 162(35): 1413-1417.Subcutaneous injection of liquid fatty materials to enhance penile girth induce sclerosing lipogranuloma of the penis. In spite of its well known severe consequences there has been a persistent use of this practice in non-medical circumstances.The aim of this paper is to present our observations with staged penile skin reconstruction for sclerosing lipogranuloma and to evaluate postoperative complications in a retrospective manner.Between 2008 and 2020, 17 patients underwent surgery to treat sclerosing lipogranuloma of the penis by staged penile skin reconstruction at our department. Complete exscision of the involved tissue was performed, then the denuded penile shaft was inserted into a subcutaneous channel on the anterior side of the scrotum during the first stage. The second stage of reconstruction consisted of releasing the penile shaft from the scrotum. The second stage was performed merely on 9 in 17 patients.According to the Clavien-Dindo classification system, 3 grade I and 1 grade I complications occurred in the postoperative period after the first and second stage, respectively. Grade II-V complications were not observed. 7 of 9 patients who underwent both stages were satisfied with the final result, 2 patients had minor correction surgery 6 months and 9 years following the second stage. 1 of 8 patients who underwent only the first stage had minor correction surgery 4 months following the operation.In case of sclerosing lipogranuloma of the penis, excision of the affected tissue and reconstruction of the penile skin are indicated. Advantages of using scrotal skin flaps are that colour and elasticity of the scrotal skin are similar to penile skin, erogenous sensation of the scrotal flap remains intact. Applying staged penile skin reconstruction with scrotal skin flap has the advantage of few postoperative complications and it is easy to perform. Orv Hetil. 2021; 162(35): 1413-1417.

SUMMARY: Periorbital lipogranuloma is a rare complication after ESS and presently lacks specific imaging reports. The purpose of this study was to describe the CT and MR imaging features of periorbital lipogranuloma. We retrospectively reviewed 9 patients with histology-confirmed periorbital lipogranuloma. All 9 patients underwent CT and MR imaging. Five lipogranulomas were located in the right eyelid and 4 in the left eyelid, which extended into the extraconal space to some degree. The lesions displayed an irregular shape and had an ill-defined margin. Multiple, specked, or nodular foci containing fat were scattered within these lesions. The lesions demonstrated moderate heterogeneous contrast enhancement on contrast-enhanced MR imaging. The TICs showed a persistent pattern (type I) in 6 patients undergoing DCE MR imaging. Thus, an ill-defined, irregular-shaped periorbital mass with multiple foci containing fat, combined with an ESS history, can help to accurately diagnose this entity.

An eyelid or orbital lipogranuloma can occur following nasal packing with liquid paraffin, petroleum jelly or an antibiotic-based cream. It usually presents a few weeks or months after the initial procedure. We present a report of three such cases of sclerosing lipogranuloma involving the eyelid, which occurred following a sinonasal surgery where nasal packing using petroleum jelly was performed. The typical clinical course and the classical histopathological features are highlighted. All cases were diagnosed by histopathological examination as sclerosing lipogranuloma. Complete surgical removal resulted in complete resolution on 1 month follow-up. The diagnosis is based on a high degree of suspicion following a detailed history of prior use of lipid-based products for nasal packing following endonasal surgery. Histopathology is diagnostic. Surgical excision is the treatment of choice, however, due to its infiltrative nature, it may be difficult to obtain a complete cure.

Periorbital lipogranuloma following autologous fat injection into the forehead for cosmetic facial augmentation is a recently described adverse outcome. Patients have typically been treated with surgical excision. This study evaluates the clinical characteristics of periorbital lipogranulomas, and the non-surgical treatment outcomes of these patients. This is a noncomparative, interventional case series. A retrospective analysis of clinical data and radiographic images was performed of patients with periorbital lipogranuloma following autologous fat injection. Objective treatment outcomes after intralesional triamcinolone injection and/or oral prednisolone were evaluated by measuring the size of the lipogranulomas pre- and post-treatment. Cosmetic outcomes were also assessed by the subjective satisfaction at the last visit. Twenty-seven patients were identified with periorbital lipogranuloma following facial autologous fat injection. All patients were female, the mean age was 40 ± 10 years, and 19 patients received cryopreserved fat. Twenty-one patients underwent non-surgical corticosteroid treatment. ‘Resolution’ was achieved in 15 patients (71 %), and ‘Partial Resolution’ was achieved in 5 patients (24 %). One patient (5 %) who took oral prednisone alone showed ‘No Response’. Cosmetic outcomes were classified as ‘Very Satisfied’ in 16 patients (76 %), ‘Satisfied’ in 4 patients (19 %), and ‘Dissatisfied’ in 1 patient (5 %) after corticosteroid treatment. Periorbital lipogranuloma following autologous fat injection may be diagnosed by history, physical exam, and orbital imaging. Non-surgical corticosteroid treatments showed a good response with few adverse effects and should be considered as a first line of treatment of periorbital granulomas prior to conducting surgical excision. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A few cases of subcutaneous nodules with the histological findings of membranous lipodystrophy-like changes have been reported in the literature. However, reports of membranous lipodystrophy-like changes caused by trauma are exceedingly rare. We report two cases of traumatic lipogranuloma that had linear and multiple lesions showing membranous lipodystrophy-like changes and were induced by safety belt trauma after a car accident. These patients showed peculiar changes in their subcutaneous fat and had linear patterned, multiple, nodular lesions with membranous lipodystrophy-like changes caused by trauma.

Sclerosing lipogranuloma is a rare and subcutaneous granulomatous reaction, which is a local reactive process after injury to adipose tissue. 1,2 This benign which is a local reactive process after injury to adipose tissue. 1,2 This benign lesion has been reported to involve many different organs, 3,4 particularly those of the genitourinary system. 5,6 Although computed tomographic and magnetic resonance imaging findings of sclerosing lipogranuloma of the scrotum have been reported,7-9 only a few have described the sonographic features of the lesions. Because sonography is a primary modality in the evaluation of the scrotum, it is important to know the sonographic findings of this lesion to assist in narrowing the differential diagnosis of palpable scrotal masses. We report the sonographic appearance of sclerosing lipogranuloma of the scrotum.

We report on a rare manifestation of Erdheim-Chester disease with intramuscular lipogranuloma. The patient was a 66-year-old man who noted a soft tissue mass in the right quadriceps femoris muscle. Radiographs revealed symmetrical osteosclerosis in the diametaphysis of both femora and tibiae. An open biopsy revealed a proliferation of lipid-laden histiocytes in the femoral bone marrow and the quadriceps femoris muscle. To our knowledge, this is the second case of Erdheim-Chester disease involving muscle.

Sclerosing lipogranuloma is a granulomatous reaction to the injection of a high-viscosity fluid in the tissues for the cosmetic purpose of improving body contour; lesions on the extremities and buttocks are commonly the results of injections of therapeutic agents in oily vehicles. Exenatide, once-weekly injection, is a therapeutic method for patients with type 2 diabetes. Here, we describe a case of exenatide once weekly induced eosinophilic sclerosing lipogranuloma at the injection site of a 62-year-old patient. To the best of our knowledge, the histopathologic features of this adverse event have not been reported in the medical literature.

Objectives The authors aimed to report 5 cases of patients with penile lipogranuloma–induced full necrosis of penile skin, wherein they obtained good results from simultaneous implementation of Y-V incision to prevent the shortening of penile length together with bipedicular scrotal flap. Methods The full excision of penile lipogranuloma and a bipedicled scrotal flap was performed. After finishing the scrotal flap, for extension in length, the authors performed the inverted V incision on the upper skin of followed by partial resection of suspensory ligament and sutured up to subcutaneous tissue in the inverted Y shape, extending the dorsal portion skin toward the penis. Results There was no shortening in length of the penis or reduction in girth and the resulting penis had no difference to normal skin of penis, with almost no contraction of the scrotum, and all patients were satisfied with the visual postoperative shape of the penis. Conclusions The authors had performed a complete excision of paraffinoma in patients with penile paraffinoma with concurrent skin necrosis and obtained good outcomes of preventing the shortening of penile length by performing a bipedicled scrotal flap with Y-V incision using the scrotal skin.

Purpose Laser canaliculoplasty is widely used to treat lacrimal duct obstruction. We describe 12 patients in whom eyelid lipogranuloma developed subsequent to laser canaliculoplasty, followed by tobramycin and dexamethasone, ofloxacin, or erythromycin ointment injected in the lacrimal duct. Methods Clinical history, ocular workup, and CT were performed. Histopathologic examination was performed after eyelid tissue excision. Results Over a period of 3 years, 12 patients were diagnosed with eyelid lipogranuloma caused by diffusion and deposition of ointment. Seven of 12 patients were injected with tobramycin and dexamethasone ointment, 3 patients were injected with ofloxacin ointment, and 2 patients were injected with erythromycin ointment. Histopathologic features of the excised tissue included multifocal spaces surrounded by multinucleated giant cells, considered to be lipogranulomatous inflammation. Conclusions The incidence of lipogranuloma caused by transcanalicular ointment injection after laser canaliculoplasty is low. Surgical excision of the lipogranuloma should be performed only when it becomes relatively localized and has passed the acute phase of inflammation to avoid the recurrence of lipogranuloma and diffusion of the inflammation. A cosmetic outcome should be considered, and simultaneous blepharoplasty with transplantation of herniated fat pads may be performed in either or both eyelids to achieve a satisfactory appearance. Injection of ointment in the lacrimal duct should be avoided, as it might create unnecessary complications when a new channel is created or when canalicular walls are penetrated. Local massage after ointment injection is not recommended.

Objective: Lipogranuloma is a rare inflammatory reactive process related to exogenous or endogenous lipids with an admission to the dermis and subcutis. It is described most frequently in the penis and scrotum of young adults. Lipogranuloma of the female genitalia is a rather uncommon condition. The lesion is histopathologically characterized by fat vacuoles with foreign body type giant cells and scattered lymphocytes. Case: We described an incidental lipogranuloma of the cervix in a 60-year-old woman who presented with total uterine prolapse. Conclusion: Although lipogranuloma mostly occurs in young male patients, especially in the genital tract, clinicians should be aware of this entity in the cervix of a postmenopausal woman with uterine prolapse, which may challenge the differential clinical diagnosis. © 2007 Springer-Verlag.

Purpose: To investigate periorbital lipogranuloma cases that developed after autologous fat injection and to determine various treatment outcomes from these cases. Methods: This retrospective study involved 27 patients who presented with periocular mass (final diagnosis of lipogranuloma) and had history of facial autologous fat injection. The collected data included information on patient sex, age, clinical presentation, number and site of fat injections, interval between injections, duration from injection to symptom onset, fat harvesting site, use of cryopreservation, and treatment outcome. Results: The most common presenting symptom was palpable mass (92.6%), followed by blepharoptosis and eyelid edema. The mean time from injection to symptom onset was 13.6 ± 29.2 months (range, 2 to 153 months). Patients were managed by intralesional triamcinolone injection (six patients) and surgical excision (three patients); 18 patients were followed without treatment. Among the six patients who underwent intralesional triamcinolone injection, five showed complete resolution, and one showed partial resolution. Among the 18 patients who were followed without management, three showed spontaneous resolution over a 5-month follow-up period. Conclusions: Lipogranuloma can develop in the eyelid after autologous fat injection into the face. Both surgical excision and intralesional triamcinolone injection yield relatively good outcomes. Simple observation can be a good option because spontaneous resolution can occur in a subset of patients.

Background Autologous fat injection into the face is a commonly used technique in plastic surgery. Autologous fat is claimed to be a safe soft-tissue filler without a foreign body reaction. This article reports on several cases of periorbital lipogranuloma after autologous fat injection for facial augmentation. Methods This was a retrospective, non-comparative and interventional case series. The authors identified nine patients with periorbital lipogranuloma. All patients had a history of previous autologous fat injection into the face by different plastic surgeons. A medical record review was performed for clinical history, radiological and histopathological studies, and treatment. Results Nine patients developed periorbital granuloma after autologous fat injection for facial augmentation. Eight of the patients had received two injections of autologous fat, and seven patients had undergone a second injection with their cryopreserved fat tissue. Erythematous swelling of the upper eyelid was refractory to antibiotic and steroid treatment, and surgery was required to resolve the inflammatory reactions in six cases. Histopathological evaluation revealed features of a lipogranulomatous reaction, with collection of histiocytes and foreign-body type giant cells around variable-sized microcysts containing lipid materials. Conclusions Lipogranuloma can develop in the eyelid following autologous fat injection to the forehead or glabella. Clinicians should be aware of this potential complication of a granulomatous reaction following autologous fat injection. Techniques for the injection and preservation of autologous fat should be refined.

Sclerosing lipogranuloma is a rare, benign disease which is a peculiar granulomatous reaction of fatty tissue. This disease affects multiple organs and the majority of cases are secondary to exogenous foreign bodies. The authors report a case of primary sclerosing lipogranuloma of the rectum mimicking a submucosal rectal tumour.

The cytopathology of a lipogranuloma of external origin is reported in the eyelid of a 32-year-old man excised 1 year following regional exposure to an explosion of hydraulic oil under high pressure. The foreign lipids were still present in chronic lipogranulomas with intercellular lipid-filled cysts surrounded by macrophages and giant cells containing intracellular lipid-filled vacuoles. These indicate efforts in storage and very slow digestion. Secondary fibrosis in the region of the lipogranuloma was an important associated process. In view of the widespread technical use of hydraulic oily fluids under high pressure, it is recommended that these fluids be biodegradable.

A-25-year-old man was admitted because of a painless tumor of the scrotum. The patient denied a history of exogenous material injection and trauma in the scrotum. Physical and radiological examination revealed a mass in the scrotum, and blood laboratory tests showed no significant findings except for mild eosinophilia (5.6%). Resection of the mass was performed. The mass was isolated and located in the subcutaneous tissue of the scrotum. The mass was rectangular and symmetrical, and measured 65 x 45 x 15 mm. Histologically, the mass was composed of adipose tissue with fibrosis. Many epithelioid granulomas with multinucleated giant cells of foreign body and Langhans' types and heavy infiltrates of lymphocytes and eosinophils were recognized. Characteristically, the lesion showed broad coagulative and lytic necrosis. Congestion and edema suggestive of ischemia were seen in some areas. Special stains for acid-fast bacteria, gram-positive bacteria and fungi failed to detect any microorganisms. Polymerase chain reaction for mycobacterium tuberculosis revealed no reaction products. Immunohistochemically, the majority of lymphocytes were CD45RO-positive T cells, and S-100 protein-positive cells and CD68-positive macrophages were scattered in small amounts. The appearances were typical for sclerosing lipogranuloma except for the necrosis. Although the pathological mechanism of the broad necrosis is unclear, the necrosis might be the result of ischemia. Our case suggests that primary sclerosing lipogranuloma of the scrotum might show broad necrosis, and that T-cell-mediated immune response might play a part in the formation of lipogranuloma.

We report the imaging findings of sclerosing lipogranuloma. Sclerosing lipogranuloma is a peculiar granulomatous fatty tissue reaction. The majority of the cases occur in the genital and urinary tracts. To our knowledge, the CT and MR images of this rare entity have not been reported in the English literature. We present a case that was suspected to be sclerosing lipogranuloma of the male genitalia on CT and MR images and was diagnosed by open biopsy.

This report describes the unusual occurrence of lipogranuloma at the incision site of dacryocystorhinostomy. Four patients had soft cystic masses after external dacryocystorhinostomy for acquired nasolacrimal duct obstruction. This was attributed to the antibiotic ointment vehicle that coated the petroleum jelly-impregnated gauze placed intranasally to prevent epistaxis. Postoperatively, all four patients had an encapsulated cystic mass within 3 weeks. Three of the masses were excised under local anesthesia and one was aspirated. None of the masses recurred. [Ophthalmic Surg Lasers 1996;27:713-715.]

Purpose To report the treatment and histopathological findings in two cases who developed eyelid swelling, proptosis and diplopia due to orbital and lid lipogranuloma after endoscopic surgery of the maxillary and ethmoidal sinuses. Methods To relieve the proptosis and diplopia, debulking surgery was done on the eyelids and orbit. The tissue removed was sent for histopathological examination. Results The two patients improved after surgery. The eyelid swelling, proptosis and diplopia subsided and ocular movements became normal. Histopathologic examination disclosed an extensive lipogranuloma. Conclusions Extensive orbital and eyelid lipogranuloma causing proptosis and diplopia is a rare complication of endoscopic sinus surgery, and can be relieved by surgical debulking.

Sclerosing lipogranuloma is a rare, benign disease that can affect several organs, particularly of genitourinary system in males. The majority of the cases are secondary to exogenous foreign bodies. The masses are composed of granulomatous tissue formed around an either exogenous or endogenous lipomatous substance. We describe a 47-year-old male patient who presented with a growing, painless scrotal mass on physical examination. The mass was in 20 cm diameter and the laboratory findings were in normal limits. Pathologic evaluation confirmed the diagnosis of scrotal sclerosing lipogranuloma. To the best of our knowledge, this is the biggest scrotal sclerosing lipogranuloma case in the literature. We aimed with this presentation to keep in mind this benign lesion and also to assist the algorithmic approach.

An analysis of lipids and histological examination were performed on tissues resected from 2 patients with sclerosing lipogranuloma of the scrotum. The clinical course and histological characteristics were consistent with those reported previously for typical primary sclerosing lipogranuloma of the male genitalia. There was no history of the injection or topical application of oils or fats. Both of our patients had eosinophilia and the lesions showed eosinophilic infiltration. Complete natural regression occurred several months after partial resection of the lesion in both cases, and no recurrence has been noted during follow-up. This lipid analysis and histological study revealed that no exogenous fatty elements were present and suggested that degeneration of endogenous fat due to some allergic mechanism might be involved in the development of sclerosing lipogranuloma. The eosinophilia associated with this disease and its spontaneous regression after partial resection also support this assumption.

Penile augmentation by injection of petroleum jelly is still performed by nonmedical practitioners abroad and causes foreign body reactions with resultant scarring, deformity, and ulceration. Surgical treatment involves removal of the foreign material and granuloma, followed by scrotal flaps, inguinal flaps, free flaps, or split-thickness skin grafts. We present the use of native penile skin for coverage after resection of oleogranuloma in the first case of which we are aware. Local penile skin coverage allows for an excellent surgical result, with many potential advantages over flaps or skin grafts.

Five cases of primary sclerosing scrotal lipogranuloma were examined histologically and immunohistochemically. Every case lacked a history of injection or trauma, and revealed common histological features: a typical granuloma composed of epithelioid cells and multinucleated giant cells, and inflammatory infiltrates of eosinophils, lymphocytes and macrophage/monocytes in the interstitium. Immunohistochemistry disclosed the epithelioid cells and multinucleated giant cells of the granuloma to be monocytes in nature, as both types of cells were positive for lysozyme, alpha-1-antitrypsin, alpha-1-antichymotrypsin, and KP-1. In the interstitium, KP-1 positive monocytes, L-26 positive B lymphocytes, UCHL-1 positive T lymphocytes and S-100 protein positive Langerhans-like cells were frequently found. S-100 protein positive cells could not be detected in the granuloma. Primary sclerosing lipogranuloma of the scrotum, therefore, is a peculiar inflammation characterized by granulomas consisting of monocytes and marked tissue eosinophilia of unknown etiology.

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.

A lipogranuloma is an inflammatory reactive process associated with exogenous or endogenous lipids, and it's occurrence in the breast has rarely been reported. Osseous metaplasia, which is used to describe bone formation in abnormal locations, can develop from several conditions such as trauma or a tumor. However, few studies have reported benign breast lesions that have been seen as osseous metaplasia. We present a case of a benign calcified breast lesion that developed after a traumatic treatment process called "Bu-Hwang", and it was confirmed as a lipogranuloma with osseous metaplasia. To the best of our knowledge, this is the first reported case of a lipogranuloma with osseous metaplasia in the breast.

Although the injection of paraffin, mineral oil, and silicon into body parts began to be described in the 19th century, similar procedures had been practiced before that time (1). Women undergo wrinkle correction and breast augmentation, whereas men seek to achieve erectile enhancement and penile enlargement (2–5). Reports on the development of subcutaneous nodules at the sites of injection abound – commonly referred to as sclerosing lipogranuloma (SL) and paraffinoma (6). SL and paraffinoma are types of foreign body panniculitis that are characterized histopathologically by fat globules that vary in size, replacing subcutaneous fat tissue. These bodies are surrounded by multinucleated foreign body giant cells and are associated with chronic granulomatous inflammatory reactions, free fat droplets, hyalinization of fibrous tissue, fibrosis; calcification can occur in long lasting lesions (6). Visceral lesions of LG are rare and can lead to death (7, 8). We report an unusual case of SL with widespread cutaneous lesions and pulmonary compromise.

Sclerosing lipogranuloma (SLG) is a rare disease that occurs in the male genital region. We report here three cases of SLG, including two of Y-shaped lesions in the penile base forming an intrascrotal mass, as well as a patient with a mass in the epidydimal region. All three lesions histologically exhibited formation of multiple granulomas consisting of multinucleated giant cells and epithelioid cells, in the fibroadipose tissue or around the epidydimis, in association with eosinophil infiltration. Membranocystic changes were found within the cytoplasm of multinucleated cells. In the two patients with scrotal lesions, membranocystic changes were positive for diastase-PAS reaction and on Sudan black B staining in dewaxed sections. CD68 staining was strongly positive in multinucleated giant cells and epithelioid cells. Most of the lymphocytes infiltrating the lesions were T cells associated with some S-100-positive dendritic cells. T-cell mediated immune reaction appears to be important in the histogenesis of SLG. The histogenesis is generally considered to be a foreign-body reaction to degenerated or damaged fatty tissue or lipids, but no apparent causative factors can be identified in some reported cases. All three patients in the present study had a good clinical course after biopsy or surgical excision. We thus report three cases of SLG including an unusual case in the epidydimal region, with some considerations regarding the histogenesis of SLG.

During the past 5 years we have seen 10 patients who had developed sclerosing lipogranuloma of the lid and orbit after endonasal sinus surgery with subsequent ipsilateral monocular haematoma. The histopathological examination of all and the additional nuclear magnetic resonance spectroscopic examination of four surgical specimens in combination with the typical clinical course led to the conclusion that the granulomas were caused by small paraffin droplets. These in turn stemmed from the ointment plugs applied to the sinuses at the end of the operation, and were washed out into the surrounding tissues by the postoperative haemorrhage. As the chronic and recurring granulomas can lead to considerable cosmetic and functional impairment, the application of ointment plugs at the end of sinus surgery should be abandoned, especially when peri- or postoperative bleeding occurs.

We report a case of primary scrotal sclerosing lipogranuloma. A 39-year-old man who had complained of a painless intrascrotal mass was introduced to our hospital for detailed examinations. He denied having received any injection of exogenous substances or having suffered from any trauma. Physical examination revealed a U-shaped elastic hard mass surrounding the penile shaft in the scrotum. T2-weighted magnetic resonance imaging (MRI) demonstrated an ill-defined U-shaped lesion which exhibited relatively low signal intensity. Primary scrotal sclerosing lipogranuloma was the most suspected. The mass gradually disappeared after 47 days from tumor open biopsy for definitive diagnosis. We found 227 cases reported in Japan, and we discuss the diagnosis, treatment and clinical features with reference to previous reports.

We presented 2 cases of lipogranuloma of the cheek following autologous fat injection. Facial autologous fat injection for soft tissue augmentation is a frequently used technique in the field of plastic surgery. Although this procedure was thought to be a safe procedure without foreign body reactions, there had been several case reports on lipogranuloma following autologous fat injection, especially into the periorbital area. In our cases, we experienced delayed lipogranulomas of the cheek area and successfully treated them with perioral excision.

Sclerosing lipogranuloma of the male genitalia is a rather uncommon condition presenting with subcutaneous masses of the penis and the scrotum. The masses are composed of granulomatous tissue formed around an either exogenous or endogenous lipomatous substance. In case of incomplete resection the masses show a rapid recurrence, thus mimicking a neoplastic lesion. On the basis of a case report a review of this entity in the literature is presented here.

Sclerosing lipogranuloma is an uncommon, benign condition that can affect several organs, particularly of the genitourinary system in males. We describe a patient who presented with an intratesticular mass on physical examination. Pathologic evaluation confirmed the diagnosis of testicular sclerosing lipogranuloma. Most case reports involve self-injection with a foreign substance that is pathognomonic. Treatment is often conservative after establishing the diagnosis.

Lipogranuloma is a rare benign disease accompanied by a reactive inflammatory process related to exogenous or endogenous lipids. We report a case of lipogranuloma of the lung mimicking pulmonary neoplastic disease in a 57-year-old woman, who presented with the symptom of coughing for a month. The diagnosis of lung cancer was considered for the CT finding of a mass in right lower lobe. The patient underwent subsequent operation, and pathological examination of the surgical specimen revealed a stromal lesion consisting of lipid vacuoles with foreign body type giant cells and scattered lymphocytes. The final diagnosis of lipogranuloma of the lung was established. Clinicians should be aware of lipogranuloma in the lung, which can be easily confused with lung tumors or other benign diseases. A careful differential diagnosis is necessary.

We present a case of sclerosing lipogranuloma of the penis in a 25-year-old man of Burmese origin complicating injection of an unknown non-biodegradable oily foreign material into his external genitalia. Despite frequent complications, penile augmentation with exogenous paraffin material is still practised in some parts of the world. Sclerosing lipogranuloma is a rare condition in Australia that dermatologists need to consider in the differential of a genital ulcer or indurated penile mass, particularly in young men from South-East Asia. A causal relationship between the procedure and adverse events may not be made because complications are frequently delayed for many years. A high degree of clinical suspicion and a skin biopsy is essential, as a history of injection may not be disclosed.

To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes.Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years.The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up.The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.

Sclerosing lipogranuloma of the male genitalia without a history of injection of exogenous material is extremely rare. This is the first case reported from a Canadian center. This 33 year old man developed sclerosing lipogranuloma of his scrotum 3 months after being diagnosed with infectious mononucleosis. There was no history of injection of exogenous substances or trauma. His lesion was painless, sudden in onset, "Y-shaped", associated with eosinophila and spontaneously regressed after partial resection. A review of the available English literature on sclerosing lipogranuloma from 1966 to 2001 was completed to compare our case report to previously available reports. The results show definite differences in the presentation of primary versus secondary sclerosing lipogranuloma. Sixty-eight per cent of the cases of primary sclerosing lipogranuloma involved the scrotum only while 63% of secondary sclerosing lipogranuloma involved the penis only. Seven per cent of lesions attributed to primary sclerosing lipogranuloma were painful compared to 69% of secondary sclerosing lipogranulomas. Cases of primary sclerosing lipogranuloma were often described as "Y-shaped" and were unlikely to recur. Understanding the typical presentation of this condition will allow future cases to be recognized more easily and managed appropriately. Primary sclerosing lipogranuloma may be diagnosed by fine needle aspiration or excisional biopsy and then managed conservatively avoiding more complex and invasive surgery.

We report a series of 45 patients visiting our clinic with distorted contour of the nose after having their noses augmented with injectable substances. The most common clinical presentation was a palpable mass on the dorsum of the nose, erythema with or without telangiectasia on the overlying skin, and nodularity of the nose. The onset of symptoms varied from 1 to 16 years after injection. They were treated by surgical excision, but this was always followed by a saddle-nose deformity. To correct this defect, we propose a new technique of adipose tissue transplantation that yields satisfactory results. Pathological reports of the excised mass showed a foreign body granuloma known as a sclerosing lipogranuloma (paraffinoma or siliconoma).

A rare case of large bilateral sclerosing lipogranuloma with multiple calcifications of gluteal region is described in an old female patient affected by a cerebrovascular disease. The lesions appeared as firm, nontender, plaques, 9-10 cm in diameter, covered with hyperpigmented skin. This uncommon disorder is discussed on the basis of data obtained from an extensive literature review. The term "sclerosing lipogranuloma" was coined in 1950, and it defines a disease of the subcutaneous fat, which for a trauma or unknown reasons undergoes necrosis of fat cells with the release of fat droplets into intercellular spaces and a peculiar local sclerosing granulomatous reaction of fatty tissue. The cytosteatonecrosis and sclerosing lipogranuloma, post-traumatic or secondary to injection of exogenous oily substances, usually localized in the breast of women and in genitalia of men, are relatively well known. Sclerosing lipogranulomatosis of the orbita and eyelides, an infrequent but severe complication after endonasal surgery, has also been reported. Rarely, the lipogranuloma can be spontaneous or idiopathic or primitive. A particular form of genetic diffuse lipogranulomatosis is the Farber's syndrome, firstly described on 1947. In our patient, the absence of trauma seems to indicate a primitive lipogranuloma. The presence of an acute rheumatic syndrome responsive to corticosteroids, and the positivity of antimitochondrial autoantibodies are in accordance with the report of sclerosing multiple lipogranulomatosis associated with a lupus-like syndrome. Because of the long duration and the absence of acute local symptoms, this syndrome can be considered benign with favorable prognosis, but the physician should know it.

Chronic lipogranuloma of anterior orbit and the eyelids is a rare inflammatory pseudotumor with a high tendency of recurrence. It is most commonly related to prior endonasal sinus surgery.We report on three patients with chronic lipogranulomata who were treated at the university eye-hospital of Düsseldorf during the last 8 years. These cases are discussed individually and longterm results are presented.Three patients underwent endonasal surgery with postsurgical use of paraffin nasal packing prior to the occurrence of chronic lipogranulomata. Histologic findings uniformly revealed granulomatous processes but in none was there any sign of a systemic granulomatous disorder (such as Boeck's disease). Additionally, one of these three patients suffered from neuroophthalmologic impairment due to infiltration of oculomotore structures. Early surgical treatment if only for extended biopsy did result in immediate severe recurrence of the disease. No recurrence of the disease has been observed, however, if surgery was duely postponed.Lipogranulomata seem to be caused by postsurgical paraffin nasal packing. Early treatment seems to be unfavourable because of the high tendency of recurrence. Surgical removal of any tumor masses should be delayed therefore till granuloma formation has presumably come to an end. Any early surgery should be limited to a diagnostic biopsy if judged necessary.

Sclerosing lipogranuloma of the scrotum is a rare granulomatous lesion of the subcutis. To the best of our knowledge, there have been no English-language reports dealing with its cytologic findings.A fine needle aspiration specimen from a mass in the scrotum in a 62-year-old male showed epithelioid cells, multinucleated giant cells and fibroblasts, which were suggestive of sclerosing lipogranuloma. The diagnosis was confirmed by histology of the resected specimen.Fine needle aspiration cytology is useful for the diagnosis of sclerosing lipogranuloma. It is important, however, to interpret the fine needle aspiration cytology specimen in conjunction with the clinical information.