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取出破裂的硅酮植入物后出现大量炎症反应掩盖浸润性乳腺癌——病例报告及文献综述

Massive inflammatory reaction following the removal of a ruptured silicone implant masking the invasive breast cancer - case report and literature review.

作者信息

Nowaczyk Piotr, Budnicka Aleksandra, Wichtowski Mateusz, Kurzawa Paweł, Murawa Dawid

出版信息

Pol Przegl Chir. 2016 Jan 1;88(1):41-7. doi: 10.1515/pjs-2016-0026.

Abstract

This paper presents a case of a patient with invasive ductal breast cancer following breast augmentation. Following breast implants rupture in March 2013 the breast implants have been removed - histopathological examination revealed leaked silicone with inflammatory infiltration, without evidence of cancerous lesions. Diagnostic imaging revealed multiple encapsulated silicone particles and clusters of post-inflammatory macrocalcifications in both breasts. In January 2014 the patient presented with symptoms of massive inflammation of the left breast. Following surgical consultation the patient had undergone radical left-sided mastectomy with lymphadenectomy. Postoperative histopathological examination revealed a multifocal advanced invasive ductal cancer G3 pT3pN3a (vascular invasion, metastases in 11 of 12 examined axillary lymph nodes). Following surgery the patient was qualified for further treatment - chemotherapy, radiotherapy, hormone therapy. The discussion includes a review of literature on the risk evaluation of co-occurrence of breast cancers in women with silicone breast implants and presents diagnostic challenges of breast cancer in this patient group.

摘要

本文介绍了一例隆胸后发生浸润性导管癌的患者病例。2013年3月乳房植入物破裂后,乳房植入物已被取出——组织病理学检查显示有硅胶渗漏伴炎症浸润,无癌性病变证据。诊断性影像学检查发现双侧乳房有多个包膜包裹的硅胶颗粒和炎症后大钙化灶群。2014年1月,患者出现左乳房大面积炎症症状。经外科会诊后,患者接受了左侧根治性乳房切除术及淋巴结清扫术。术后组织病理学检查显示为多灶性晚期浸润性导管癌G3 pT3pN3a(血管侵犯,12个检查的腋窝淋巴结中有11个有转移)。手术后,患者符合进一步治疗条件——化疗、放疗、激素治疗。讨论内容包括对硅胶乳房植入女性中乳腺癌同时发生风险评估的文献综述,并提出了该患者群体中乳腺癌的诊断挑战。

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