Analysis of a Polytef Granuloma Mimicking a Cold Thyroid Nodule 17 Months after Laryngeal Injection

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Abstract
A 65–year-old female who received laryngeal injections with polytef (Teflon) paste for treatment of right vocal cord paralysis first noticed a small, right anterior neck mass 17 months later. Clinically this mass slowly progressed in size and was felt to be a recurrent carotid body tumor, but at surgery, 22 months after injection, a circumscribed nodule on the anterior right lobe of the thyroid was found and histologically diag-nosed as a foreign body granuloma. Scanning electron microscopy (SEM) and energy-dispersive x-ray analysis (EDXA) of material in this lesion was identical to that of polytef paste, which is a mixture of pyrolyzed poly-tetrafluoroethylene and glycerine. The possibility that deaggregated smaller particles in the polytef paste were able to migrate from the injection site resulting in this neck mass is considered.