Lethal midline granuloma. Case report and review of the Literature

Destructive diseases of the mid-face show various etiopathogenesis, some of them sometimes showing symptoms of systemic diseases that have complex diagnoses which make a specific therapy necessary. The authors describe a case of Stewart's granuloma, a rare and aggressive disease which greatly destroys the structures of the central-face with a serious prognosis making medicinal and surgical therapy difficult. The authors examine the etiopathogenesis hypothesis of these diseases, which is still not well-known and describe the diagnosis which allows us to differentiate the other forms already known, for example Wegener's granulomatosis. Immuno-histochemical, histomorphological and immunological data are important for the precise diagnosis in these cases.