Persistent foreign body granuloma developing on the face following embolization agent and stent placement: A rare case report

Abstract

Foreign body granulomas represent a complex defense mechanism developed by the body in response to foreign substances. While some granulomas remain asymptomatic, others may cause pain, swelling, or functional impairment. A 28-year-old male patient presented to our clinic with complaints of dull pain in the right temple and wounds with discharge opening to the skin in the right frontal, right maxillary, and mandibular regions. The patient’s history revealed that an arteriovenous malformation developed following trauma to the right eyelid at the age of 3, which was subsequently treated at age 18 with an embolizing agent and stent placement due to mass effect and ptosis. Within the first postoperative week, swelling, redness, and pain developed in the right eyelid and forehead, which eventually evolved into discharge opening to the skin. In the subsequent period, this discharge spread toward the maxillary and mandibular regions. A biopsy taken from the open wounds, which persisted for approximately 5 years and showed resistance to antibiotic therapy, revealed foreign body material from the stent and giant cell granuloma tissue. These findings were corroborated by digital cerebral angiography. Foreign body resection of the granuloma tissue has been planned. In conclusion, the present case exemplifies a rare and noteworthy instance of long-term complications of foreign body reactions.