Metallic Foreign Body

A patient with a history of well-controlled HIV and bipolar affective disorder presented to the clinic with a history of recurrent intermittent periorbital eyelid swelling and pain of 16 years duration. His symptoms began six months after receiving “black market facial fillers” of an unknown substance in a hotel room from a stranger who claimed to work in a physician’s office. There was a firm, mildly tender nodule along the right lower eyelid. Anterior segment and fundus examinations were unremarkable. CT scan of the face without contrast revealed a thin, radiodense tubular 2.8 cm structure in the right premaxillary soft tissues. A lower eyelid and upper cheek dissection was performed. A 28 x 1 x 1 mm tubular metallic foreign body, which appeared to be a metallic needle or cannula, was retrieved from the periocular tissue, approximately 10 mm inferior to the inferior orbital rim. Histopathology of surrounding brown-stained tissue demonstrated iron deposition with granulomatous inflammation and clear spaces consistent with “filler.”

Presentation Date: 05/06/2021

Issue Date: 05/21/2021