A graphite foreign body granuloma causing palatal perforation. Case report and literature review

Abstract

Purpose To present an unusual case of a graphite foreign body granuloma causing palatal perforation and review the literature on graphite deposition in the oral mucosa. Methods A 62-year-old female patient presented with a macule on the hard palate clinically consistent with a blue nevus. During excisional biopsy a black nodular mass was found beneath the macule that extended through a tunnel-like palatal deficit towards the nasal cavity. Oroantral communication was verified by a computed tomography scan indicating a diagnosis of malignant melanoma. Results Microscopic examination showed a graphite foreign body granuloma. It was suggested that the core was implanted in a thin area of the palatal bone and the foreign body granuloma caused the tunnel-like resorption. Conclusion Graphite tattoo may be included in the differential diagnosis of solitary pigmented lesions of the oral mucosa and should be excised, as it may cause tissue destruction though the development of a foreign body granuloma reaction.