PMC7771506_01
(a) Presurgical images, significant bilateral fronto-orbital defect, predominantly right side. (b and c) control 3 years after surgery, significant remission of bone deformity.
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F1
Torreon Coahuila was referred in November 2015 for sudden increase in volume of the right fronto-orbital region. The patient reported a contusion in the right frontal region 1 month before and was underwent treatment with metronidazole but not improvement was observed [Figure 1a-c].
PMC7771506_02
(a-c) (Upper quadrants) Presurgical gadolinium-enhanced T1-weighted magnetic resonance imaging showing heterogeneous enhancement mass in the bilateral fronto-orbital region predominantly on the right side, we can see a hypodensity in relation to methyl methacrylate. (d-f) (Lower quadrants) Computed tomography scan control 6 months after the medical treatment with resolution of the deformity.
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F2
In January 2016, a magnetic resonance imaging study reported heterogeneous enhancement mass in the bilateral fronto-orbital region [Figure 2a-c] Pre-surgical MRI and [Figure 2d-f] post-surgical CT scan, control 6 months after surgery, causing significant craniofacial deformation a malignant neoplastic process was suspected.
Hematoxylin and eosin staining. Basophilic structure, granular, and peripheral-pseudopalisading, hemorrhagic background, and peripheral lymphocytic and polymorphonuclear infiltrate.
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F3
Histopathological findings included a multifocal foreign body-type granulomatous lesion and granulation tissue [Figure 3]. A.israelii was isolated in the tumor tissue by histopathological study by staining for hematoxylin and eosin [Figure 3].
(a and b) 3D computed tomography (CT) scan showing silicone implants in the chin and zygomatic bone, a supraorbital methyl methacrylate bar and plates in the bilateral parietal region (upper quadrants). (c and d) (Lower quadrants): 99mtechnetiumUbiquicidin (29-41)/three-phase bone single-photon emission computed tomography/CT scan control 3 years after the last surgical intervention showing diffuse uptake of the radiotracer, suggestive of an inflammatory process, an active infectious process is ruled out.
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F4
In 2017, the supraorbital methyl methacrylate bar was surgically removed [Figure 4a and b]. In February 2020, 99mTc three-phase bone SPECT/CT scan and 99mTc-UBI 29-41 bone SPECT/CT scan was performed, and a negative infection result was reported [Figure 4c and d].