What is the Treatment for an Injection Granuloma?

Question

I had an injection of epinephrine due to anaplaxis reaction and now have an injection granuloma that is sometimes painful and itchy.

Peter A. Aldea, MD · Answer

An injection granuloma is the body's reaction for a retained foreign body or substance. It can resolve with a simple incision and drainage. If it does not -- you may need to have it excised and repaired properly.

Arnold R. Oppenheim, MD (retired) · Answer

An injection granuloma occurs when a medication is inadvertently injected into the fat rather than the muscle. This causes fat necrosis (fat death), scar formation, and sometimes calcium deposits. If the patient can not recall receiving an injection, these can feel like a soft tissue mass and occasionally  lead to an erroneous diagnosis of sarcoma.
    Even under the microscope, this can be a tricky diagnosis. I remember as a pathology resident, this can pose a very difficult call in evaluating a  breast mass...that tissue being a fairly common area for fat necrosis.
  It is felt that women develop more of these injection granulomas due to the larger amount of subcutaneous fat. There may be a hormonal reason for this also.
    Decreased blood flow (hypovolemia), also makes one more prone to an injection granuloma. The fact that you were in anaphylaxis (to what?) made you more susceptible to an injection granuloma.
    It may be best treated with judicious, dilute corticosteroid. Your physician must be careful since steroids too can cause granulomas. However, they do often break them up, hence their use in this situation.
  Otherwise, they can be excised by a surgeon.
   By the way, send a thank you note to the person who handled your emergency each of your birthdays!

What is the Treatment for an Injection Granuloma?

Answers (2)

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