Polyacrylamide soft tissue filler nodule mimicking a mucoepidermoid carcinoma

Adverse reactions to injectable soft tissue fillers

“…268 The histopathologic findings of the local reaction at the cheek mucosa after injection of polyacrylamide hydrogel has in one case been reported to mimic a mucoepidermoid carcinoma. 269 POLYALKYLIMIDE GEL Key points d Permanent hydrophilic filler composed a polyalkylimide polymer d Complications secondary to this filler include edema, bruising, nodules, and infections, but no granulomas have been described d Histopathologically, this filler appears as basophilic amorphous material with granular appearance surrounded by sparse numbers of epithelioid histiocytes, foreign body multinucleated giant cells, neutrophils, and red cells This is a permanent translucent gel made of a hydrophilic biopolymer with 96% sterile water and 45% polyalkylimide polymer (Bio-Alcamid; Polymekon, Brindisi, Italy), and different from polyacrylamide. It has been used to increase volume in the cheeks in HIV patients with facial lipoatrophy related to antiretroviral therapy and for gluteal augmentation, correction of irregularities after liposculpture, scar depressions, and posttraumatic subcutaneous atrophy and filling of pectus excavatum or other malformations of the skeleton.…”

Foreign body in the cheek following crown-lengthening surgery

“…In this case report, the radio opacity of the resin used was observed in computed tomography to be close to that of bone's radiological aspect characteristics, and lead to misdiagnosis during scanner interpretation. Previous studies have reported radiographic images mimicking mucoepidermoid carcinomas [10] or congenital lesions [11], and after surgery, inclusions of foreign bodies in the oral mucosa were revealed.…”

“…Foreign bodies of the oral mucosa could appear after oral surgery, dental treatments [8], traumatic injuries [9], maxillofacial skin augmentation procedures, plastic surgery of facial skin [6,10] or self-mutilation [11]. When clinical manifestations appear, they are related to the volume, situation and composition of the foreign body, but sometimes, inert materials may remain unnoticed for a long time [9].…”

Non-Odontogenic Oral and Maxillofacial Infections

“…Stimulatory fillers such as polylactic acid and calcium hydroxylapatite, or silicone may give rise to fibrotic nodules. Immune response to filler material or chronic infection can lead to formation of granulomas [30][31][32][33][34]. They should be treated as foreign body infections with macrolide or tetracycline, and strong consideration should be given to two-drug therapy.…”