An Unusual Presentation of Oil Granuloma in Neck: A Rare Case Report

We introduce a male patient, age 51, with 20 years history of a left sided neck swelling, slowly progressive that was resistant to antibiotic treatment without any history of trauma. The results of the Ultrasound neck and the fine-needle aspiration biopsies were suggestive of epidermal cyst. Histological analysis of an excisional biopsy indicated a haemorrhagic granulation tissue seen with variable sized oil droplets and surrounding foreign body giant cell reactions. In the head and neck, oil granuloma is a fairly uncommon condition that often presents clinically with palpable, painless lymphadenopathy. The etiology of oil granuloma has been described by two mechanisms (1) exogenous foreign body reaction to a lipid or oil-like material and the more uncommon (2) endogenous degeneration related to an allergic/inflammatory mechanism as a result of extreme heat/cold and/or trauma. Oil granuloma has been referred to as lipogranuloma, lipid granuloma, oleogranuloma, paraffin granuloma. Conclusion: This case reports one of the rare clinical findings of primary oil granuloma of the neck without any antecedent cause.