Foreign Body Granuloma

Penetration of foreign bodies may present a diagnostic challenge to the surgeon. The foreign body granuloma is a biological response of tissue to any foreign body in the tissue. The pathway of arriving to the diagnosis of foreign body granuloma becomes difficult when patient presents with non specific symptoms such as pain/ swelling, and in history- no recollection of previous trauma. The most frequent reported injury is to hand, thigh, knee and feet; these may be limited to soft tissue of may be intra articular. The time and type of presentation varies according to the immune status of the individual. In cases, where history of trauma is uncertain, the presentation is very late and the radiographic appearance may be confusing - Median time of presentation: 4 months to 20 years. The etiology of penetration wounds of foot may be varied, from thorns to fragments of wood and usually it remains masked due to its late presentation clinically. The differential diagnosis for bony reaction to an unrecognised organic foreign body can be acute and chronic osteomyelitis, bone cyst, cortical fibrous defect, pyogenic granuloma, thigh abscess and neoplasm. We present a case of old, female that presented with a swelling over right thigh since 2 years and was later diagnosed as foreign body granuloma.