Lethal Midline Granuloma: An Enigma in Diagnosis—A Rare Case Report

Prasad, Kishore Chandra; Harshitha, N; Harshita, T R; Pillai, D Aishwarya Raj; Brindha, H. S.

doi:10.1007/s12070-019-01631-z

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…4,5 The literature presents a great diversity of terminology to name this pathology, in addition there is also a clinical similarity between midfacial granulomatosis and other destructive midfacial lesions. 6 Midfacial granulomatosis, described as enigmatic by some authors, has several names: Robert Woods in 1921, "malignant granuloma of the nose", Stewart in 1933, "progressive lethal granulomatous ulceration of the nose", Tsokos in 1980, "idiopathic destructive disease of the midline. 7,8 The lesions in our patient were identical to those described by Stewart and repeated by Valerio 4 and other authors.…”

Section: Discussionmentioning

confidence: 99%

Mediofacial malignant granuloma: a case report and review of the literature

Aliou,

Ibrahima,

Sayon

et al. 2023

JOENTR

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We report a case of malignant midfacial granuloma or idiopathic midfacial granulomatosis in a 50-year-old male farmer with no previous history. He was admitted to the department in an emergency context. The history was reportedly 18 months old. He presented a symptomatology made of nasal obstruction, fever, headache and rhinorrhea with an altered general state. He consulted several health facilities. The evolution was marked by the aggravation of the symptomatology. The examination at admission noted an alteration of the general state. Examination of the ENT sphere revealed ulcerative-necrotic lesions with a destructive nasal origin, with bone sequestration, midface edema, and extension to the sinuses and hard palate. The CT scan revealed bony and cartilaginous lysis, irregular thickening of the nasal pyramid, continuity of the nasal septum, and isodensity of the maxillary, ethmoidal, and left sphenoidal sinus walls without total filling. Deep biopsies were performed under general anesthesia. Histology was consistent with a granulomatous reaction with progressive tissue destruction. Mycobacterium tuberculosis was absent. Medical treatment was initiated. The evolution was marked by the extension of the lesions, malnutrition and the appearance of generalized oedema. The patient died on the 45th day of his hospitalization in a septic shock situation. Conclusion: Mediofacial granulomatosis is a difficult lesion to diagnose and manage. It requires careful histological exploration in order to differentiate it from other mediofacial destructive lesions. The evolution is most often towards extension and lethal complications.

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Section: Discussionmentioning

confidence: 99%

Mediofacial malignant granuloma: a case report and review of the literature

Aliou,

Ibrahima,

Sayon

et al. 2023

JOENTR

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“…Lethal midline granuloma, also called lethal midline injury, is an infrequent entity first described by McBride in 1897, previously known as Stewart's granuloma or polymorphic reticulosis acording to Prasad and Gonzales 1,2 , which is characterized by the presence of an ulcerous necrotizing injury with a strong inflammatory, angiocentric, and angiodestructive component that is very aggressive and highly lethal, which also compromises the tissues of the upper respiratory tract, the oral cavity, and the midline of the face 3 . With the advancements made in immunohistochemistry, it was possible to categorize most of the cases previously designated to the NK/T-cell extranodal lymphoma, a term that was introduced by the European lymphoma classification in 2001 and was accepted by the World Health Organization in 2008.…”

Section: Introductionmentioning

confidence: 99%

Clinical spectrum of a syndromic diagnosis: Lethal midline granuloma

Martínez-Rodríguez¹,

Mora²,

Buitrago-Toro³

et al. 2022

GAMO

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A 73-year-old man presented to the emergency department for 2 months of erythema, warmth, and blushing on the tip of the nose, with progression to ulcerative and granulomatous tissue and posterior necrotizing compromise of the nasal septum, despite antibiotic schemes. A diagnosis of lethal midline granuloma was made, a disease with a wide spectrum of etiological diagnostic possibilities and usually a poor prognosis. A biopsy sample confirms a NK/T-cell lymphoma. The patient did not accept the proposed chemotherapeutic treatment. He requested voluntary discharge and later died.

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Lethal Midline Granuloma: An Enigma in Diagnosis—A Rare Case Report

Cited by 2 publications

References 2 publications

Mediofacial malignant granuloma: a case report and review of the literature

Mediofacial malignant granuloma: a case report and review of the literature

Clinical spectrum of a syndromic diagnosis: Lethal midline granuloma

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