Lethal Midline Granuloma Presenting as Facial Cellulitis.

Lethal midline granuloma (Midline granuloma, Midline reticulosis, Polymorphic reticulosis, and Angiocentric immunoproliferative lesion) is relatively a rare entity of unknown etiology characterized by a massive destruction, erosion and mutilation of the tissues of nose and upper respiratory passages. Unlike Wagner’s granulomatosis which is known for its multi organ involvement, lethal midline granuloma remains usually localized. Without therapeutic intervention it has a very high mortality. Radiotherapy is the treatment of choice which considerably improves both quality and quantity of life. Addition of chemotherapy gives additional benefit. Sporadic cases have appeared in literature from time to time under various synonyms.