PRIMARY LIPOGRANULOMA OF THE FOREHEAD

Lipogranuloma describes a uniform histologic reaction of adipose tissu e to endogenous or exogenous lipids or oily materials.(1,2) In 1900, G ersuny(3) injected liquid paraffin into the scrotum of a boy for cosme tic reconstruction following bilateral orchiectomy with satisfactory r esults. In contrast, Heidingsfeld(4) reported facial deformities follo wing subcutaneous injections of this material to reduce wrinkles. Sinc e that time, intentional and accidental administration of a wide varie ty of foreign bodies, such as soft or liquid paraffin, mineral oils, g rease or silicone, in subcutaneous tissue causing these histopathologi c changes has been described.(5-9) The term ''sclerosing lipogranuloma '' was first used in 1950 by Smetana and Bernhard(2) to describe a gra nulomatous reaction of adipose tissue resulting from some inciting eve nt (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 hist ory of trauma or subcutaneous injection of any foreign material. Diagn ostic management, histopathologic findings, and the adequate therapeut ic procedure are described and discussed with the relevant literature.