case_images: PMC11321352_01
case_images: Mass on right cheek.
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case_images: Physical examination revealed a single nodular lesion on the right cheek, which protruded slightly beyond the skin surface (Figure 1).
case_images: Ovoid, hypoechoic cystic lesion with regular borders, measuring approximately 9.3x6.6 x 9.3 mm in the subcutaneous cellular tissue plane.
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case_images: To characterise the lesion further, an ultrasound evaluation was performed, which revealed an ovoid, hypoechoic, cystic structure with regular borders measuring approximately 9.3x6.6 x 9.3 mm in the subcutaneous cellular tissue plane (Figure 2).
case_images: (a) After the first session, erythema, oedema, and inflammatory reactions are observed in the infiltrated area. (b) Hypoechoic lesion in the subcutaneous cellular tissue with slightly irregular borders of 6x7 x 3 mm. (c) New application of the enzymes with the same dilution and volume as previously mentioned. (d) Reduction of the nodular volume, leaving in its place an erythematous macule. (e) Control ultrasound shows the absence of tumours. (f) Affected area 4 years after the application.
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case_images: Day 7 after enzymatic treatment: Erythema, oedema, and inflammatory reaction were observed in the infiltrated area (Figure 3a). Ultrasound follow-up showed a hypoechoic lesion in the subcutaneous cellular tissue with slightly irregular borders measuring 6x7 x 3 mm (Figure 3b). Day 41 after enzymatic treatment: A reduction of the nodular volume was observed, leaving an erythematous macule in its place (Figure 3d). Control ultrasound revealed the absence of tumours (study without clinical alterations) (Figure 3e).