面部及眼眶播散性硅肉芽肿
Disseminated silicone granulomatosis in the face and orbit.
作者信息
Chen Tiffany A, Mercado Carmel L, Topping Katie L, Erickson Benjamin P, Cockerham Kimberly P, Kossler Andrea L
机构信息
Stanford University, School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA.
Stanford Health Care, Byers Eye Institute at Stanford, 2452 Watson Court, Palo Alto, CA 94303, USA.
出版信息
Am J Ophthalmol Case Rep. 2018 Feb 4;10:32-34. doi: 10.1016/j.ajoc.2018.01.037. eCollection 2018 Jun.
PURPOSE
To report a case of disseminated silicone granulomatosis presenting with ptosis, proptosis and vision loss.
OBSERVATIONS
A 56-year-old female presented with ptosis, proptosis, and vision loss and was noted to have palpable, erythematous masses involving the orbit, face, trunk, and body. She had a history of bilateral silicone breast implants and cosmetic facial filler injections. Orbital biopsy demonstrated non-caseating granulomas with foreign-body giant cells and vacuoles containing material consistent with silicone. Removal of the patient's breast implants and systemic immunosuppression led to dramatic granuloma regression.
CONCLUSIONS
Silicone can induce a severe, systemic inflammatory response and should be considered in the differential for facial and periorbital granulomas in patients with a history of silicone breast implants. Management of disseminated silicone granulomatosis is challenging and requires multimodal treatment with silicone removal and systemic immunomodulation.
目的
报告一例以眼睑下垂、眼球突出和视力丧失为表现的播散性硅酮肉芽肿病病例。
观察结果
一名56岁女性出现眼睑下垂、眼球突出和视力丧失，眼眶、面部、躯干和身体可触及红斑性肿块。她有双侧硅酮乳房植入物和面部美容填充剂注射史。眼眶活检显示非干酪样肉芽肿，伴有异物巨细胞和含有与硅酮一致物质的空泡。取出患者的乳房植入物并进行全身免疫抑制后，肉芽肿显著消退。
结论
硅酮可诱发严重的全身炎症反应，对于有硅酮乳房植入物病史的患者，面部和眶周肉芽肿的鉴别诊断应考虑硅酮。播散性硅酮肉芽肿病的治疗具有挑战性，需要采取取出硅酮和全身免疫调节的多模式治疗。
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