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Photographs from the patient, shows the tumor lateral to the nasal root on the right dorsal wall. (A) Frontal view; (B) Zoomed oblique view (red arrows highlight the tumor).
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A 71-year-old female patient with significant facial photoaging and no previous comorbidities sought the dermatologist because of a tumor, measuring approximately 15 mm in it's greatest axis, lateral to the nasal root on the right dorsal wall, beginning two weeks ago and growing rapidly (Figure 1).
High-frequency ultrasound shows an anechoic cylindrical structure (red arrows) in the subcutaneous layer, with smooth margins, internal echoes and few septa, suggesting a hyaluronic acid pseudocyst. (A) Longitudinal view; (B) Axial view.
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Hyaluronic acid extrusion after an ultrasound-guided needle puncture and gentle pressure applied the lesion.
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Given the dermal filler's superficiality and bolus disposition, the treatment was performed with an ultrasound-guided 18-gauge needle puncture, followed by lesion pressure that resulted in a hyaline gel extrusion (Figure 3).