Elahi Leslie, Meuwly Marie-Garance, Meuwly Jean-Yves, Raffoul Wassim, Koch Natalie
Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Department of Diagnostic and Interventional Radiology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Plast Reconstr Surg Glob Open. 2022 May 25;10(5):e4290. doi: 10.1097/GOX.0000000000004290. eCollection 2022 May.
Silicone implants were developed in 1962 for breast augmentation and became essential in reconstruction after mastectomy. Silicone "bleeding" has been described from both ruptured and intact implants and can induce disseminated granulomatosis due to the component's high fat solubility. If not adequately treated, they can lead to disastrous cosmetic and functional consequences. Because they may mimic malignancy, prompt and reliable diagnosis should be made as early as possible.
We present a clinical case description of multiple intraparenchymal and ipsi/contralateral intraganglionic siliconomas in a woman who had undergone breast reconstruction, and a literature review of the pathophysiology of siliconomas and their diagnosis and management.
Silicone migration to the contralateral breast and lymph node is rare and has seldom been described. The mechanism is still debated. Excluding malignancy is a priority, and systematic management must be respected to avoid misdiagnosis or unnecessary investigations.
A multidisciplinary approach is essential for siliconoma management. Silicone-related lymphadenopathies do not require follow-up or special treatment unless they interfere with the diagnosis of tumor recurrence. Careful observation is sufficient for asymptomatic siliconomas; however, symptomatic ones should be treated depending on skin involvement and the patient's eligibility for intervention.
硅胶植入物于1962年被开发用于隆胸，并在乳房切除术后的重建中变得至关重要。硅胶“渗漏”已在破裂和完整的植入物中被描述，并且由于该成分的高脂肪溶解度可诱发播散性肉芽肿病。如果治疗不充分，它们可能导致灾难性的美容和功能后果。由于它们可能酷似恶性肿瘤，应尽早做出迅速而可靠的诊断。
我们介绍了一名接受乳房重建的女性发生多处实质内和同侧/对侧神经节内硅瘤的临床病例描述，以及对硅瘤的病理生理学及其诊断和管理的文献综述。
硅胶迁移至对侧乳房和淋巴结很罕见，很少有相关描述。其机制仍存在争议。排除恶性肿瘤是首要任务，必须遵循系统管理以避免误诊或不必要的检查。
多学科方法对于硅瘤的管理至关重要。与硅胶相关的淋巴结病除非干扰肿瘤复发的诊断，否则不需要随访或特殊治疗。对于无症状的硅瘤，仔细观察就足够了；然而，有症状的硅瘤应根据皮肤受累情况和患者的干预适应症进行治疗。
