A graphite foreign body granuloma that caused palatal perforation. Case report and literature review

We present an unusual case of a graphite foreign body granuloma causing palatal perforation. A 62-year-old female presented with a macule on the hard palate clinically consistent with a blue nevus. On biopsy a black nodular mass was excised, establishing oroantral communication that was verified by a computed tomography scan. A diagnosis of malignant melanoma was strongly suspected, but microscopic examination showed a graphite foreign body granuloma. It was suggested that the graphite was implanted in a thin area of the palatal bone causing perforation. Graphite tattoos should be excised, both for diagnostics purposes and the possibility of causing tissue destruction by generating a foreign body granuloma reaction. Pencil core granuloma, graphite, foreign body, palate, case report.