Materazzo Marco, Vanni Gianluca, Pellicciaro Marco, Anemona Lucia, Servadei Francesca, Giacobbi Erika, Farinaccio Andrea, Pistolese Chiara Adriana, Perretta Tommaso, Chiocchi Marcello, Bruno Valentina, Tacconi Federico, Sadri Amir, De Majo Adriano, Di Pasquali Camilla, Meucci Rosaria, Santori Francesca, Cotesta Maria, Buonomo Oreste Claudio
Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.
Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy.
Front Surg. 2021 Mar 9;8:606864. doi: 10.3389/fsurg.2021.606864. eCollection 2021.
Breast reconstruction plays a fundamental role in the therapeutic process of breast cancer treatment and breast implants represents the leading breast reconstruction strategy. Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), locoregional recurrence in the skin flap, and skin flap necrosis are well-known complications following mastectomy and immediate breast reconstruction (IBR). We report a case of locoregional cancer recurrence in the mastectomy flap mimicking BIA-ALCL, in a patient who underwent 6 breast procedures in four facilities across 15 years including immediate breast reconstruction with macrotextured breast implants. Despite the rate and onset of the disease, clinicians should be aware of BIA-ALCL. Due to the risk of false negative results of fine needle aspiration, clinical suspicion of BIA-ALCL should drive clinicians' choices, aside from cytological results. In the present case, surgical capsulectomy of the abnormal periprosthesic tissue revealed locoregional recurrence.
乳房重建在乳腺癌治疗的过程中起着至关重要的作用，而乳房植入物是主要的乳房重建策略。乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）、皮瓣局部复发和皮瓣坏死是乳房切除术后即刻乳房重建（IBR）后众所周知的并发症。我们报告了一例在乳房切除皮瓣中出现局部癌症复发并酷似BIA-ALCL的病例，该患者在15年里于4家机构接受了6次乳房手术，包括使用大纹理乳房植入物进行即刻乳房重建。尽管该病的发病率和发病情况如此，但临床医生仍应了解BIA-ALCL。由于细针穿刺存在假阴性结果的风险，除了细胞学结果外，临床对BIA-ALCL的怀疑应驱动临床医生的选择。在本病例中，对假体周围异常组织进行手术包膜切除术显示为局部复发。
