A rare case of migrating dermal filler mimicking lymphadenopathy

Background: Injection of dermal fillers has been used increasingly for facial rejuvenation by practitioners of esthetic medicine. The rise in these procedures has led to more dermal filler–related complications that can mimic common pathologic conditions, such as infection and tumor. Case Description: A 30-year-old man sought treatment for bilateral submandibular nodules. Results of magnetic resonance imaging revealed bilateral masses and sonography was suggestive of cysts or lymph nodes. Analysis of sonography-guided fine-needle aspiration cytology revealed abundant acellular substance with a foreign body reaction. Practical Implications: Radiologists may not recognize the nature of the lesion without the patient's history of injectable filler, and patients may not volunteer this information. The diagnosis is also more difficult in cases of dermal filler migration away from the site of original injection. In particular, head or neck masses may manifest as possible tumor or infection, which is diagnosed as dermal filler foreign body on biopsy. The authors describe the characteristic sonographic and cytologic findings and review the literature. Increased awareness among clinicians, radiologists, and pathologists may lead to better diagnosis and patient outcomes.