Lipogranuloma of the Head and Neck

Abstract

Objective: To report a rare case of lipogranuloma of the head & neck.Case Report: We present a 33-year old female patient with a 2-month history of left neck mass refractory to antibiotic therapy. Laboratory workup and fine needle aspiration biopsy was nondiagnostic. Excisional biopsy revealed histologic evidence of a granulomatous soft tissue reaction consistent with lipogranuloma. Lipogranuloma is a very rare finding in the head and neck which typically manifests clinically with painless palpable lymphadenopathy. Two mechanisms have been described for the etiology of lipogranulomas: (1) an exogenous foreign body reaction to either a lipid or oil-like substance, and the more rare (2) endogenous degeneration secondary to an allergic/inflammatory mechanism as a result of severe heat/cold and/or trauma. Given the patient's history of motor vehicle accident 3 months prior with concurrent neck strain injury, the etiology of lipogranuloma is this case is likely due to endogenous lipid degeneration. Conclusion:This case reports the rare clinical finding of a patient with lipogranuloma likely secondary to endogenous inflammatory lipid degeneration.