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Thoracic outlet syndrome following breast implant rupture.

Mistry R, Caplash Y, Giri P, Kearney D, Wagstaff M - Plast Reconstr Surg Glob Open (2015)

Bottom Line: Histology demonstrated silicone lymphadenopathy with no evidence of malignancy.Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome.We report the unusual presentation, progression, and the ultimate surgical management of this patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia; Department of Haematology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia; and Anatomical Pathology, SA Pathology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia.

ABSTRACT
We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

No MeSH data available.


Related in: MedlinePlus

Axial MRI from first presentation demonstrating extracapsular implant rupture and axillary and internal mammary lymphadenopathy.
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Figure 1: Axial MRI from first presentation demonstrating extracapsular implant rupture and axillary and internal mammary lymphadenopathy.

Mentions: A 33-year-old woman presented with bilateral breast pain 5 years following submuscular augmentation mammoplasty. There was no history of trauma. The implants were textured silicone Poly Implant Prothese (PIP) 390 cm3 implants. Examination revealed bilateral tender D-cup breasts and tender axillary lymph nodes. Magnetic resonance imaging (MRI) demonstrated bilateral extracapsular implant rupture with bilateral internal mammary and axillary lymphadenopathy (Fig. 1). The patient elected against having the implants replaced. She underwent explantation and total capsulectomy. A selective excision of palpably enlarged bilateral level 1 axillary lymph nodes was also performed at her request. Histology demonstrated a fibrous pseudocapsule with silicone material throughout and silicone lymphadenopathy with no evidence of malignancy. The lymph nodes showed partial effacement of the architecture by nonnecrotizing granulomatous inflammation, with a prominent foreign body giant cell reaction. Clear vacuoles were seen within the cytoplasm, consistent with the presence of silicone (Fig. 2).


Thoracic outlet syndrome following breast implant rupture.

Mistry R, Caplash Y, Giri P, Kearney D, Wagstaff M - Plast Reconstr Surg Glob Open (2015)

Axial MRI from first presentation demonstrating extracapsular implant rupture and axillary and internal mammary lymphadenopathy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4387153&req=5

Figure 1: Axial MRI from first presentation demonstrating extracapsular implant rupture and axillary and internal mammary lymphadenopathy.
Mentions: A 33-year-old woman presented with bilateral breast pain 5 years following submuscular augmentation mammoplasty. There was no history of trauma. The implants were textured silicone Poly Implant Prothese (PIP) 390 cm3 implants. Examination revealed bilateral tender D-cup breasts and tender axillary lymph nodes. Magnetic resonance imaging (MRI) demonstrated bilateral extracapsular implant rupture with bilateral internal mammary and axillary lymphadenopathy (Fig. 1). The patient elected against having the implants replaced. She underwent explantation and total capsulectomy. A selective excision of palpably enlarged bilateral level 1 axillary lymph nodes was also performed at her request. Histology demonstrated a fibrous pseudocapsule with silicone material throughout and silicone lymphadenopathy with no evidence of malignancy. The lymph nodes showed partial effacement of the architecture by nonnecrotizing granulomatous inflammation, with a prominent foreign body giant cell reaction. Clear vacuoles were seen within the cytoplasm, consistent with the presence of silicone (Fig. 2).

Bottom Line: Histology demonstrated silicone lymphadenopathy with no evidence of malignancy.Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome.We report the unusual presentation, progression, and the ultimate surgical management of this patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia; Department of Haematology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia; and Anatomical Pathology, SA Pathology, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia.

ABSTRACT
We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

No MeSH data available.


Related in: MedlinePlus