Pereira Gonçalves Beatriz, Rodrigues Dos Santos Catarina
General Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Lisboa, Portugal
General Surgery, Universidade de Lisboa Faculdade de Medicina, Lisboa, Portugal.
BMJ Case Rep. 2025 Jan 4;18(1):e262040. doi: 10.1136/bcr-2024-262040.
We report a case of a woman in her late 40s with a history of breast implant surgery following breast cancer treatment. She presented with asymmetrical breast enlargement, palpable contralateral axillary lymph nodes and cutaneous nodules on both forearms. In addition, imaging evaluation revealed intracapsular implant rupture, ipsilateral internal mammary enlarged lymph nodes and multiple mediastinal lymphadenopathies. Skin and axillary lymph node biopsy demonstrated a chronic granulomatous reaction with foreign-body giant cells related to silicone. Following surgical removal of the breast implant, cutaneous nodules disappeared, and all lymph nodes decreased in size. Systemic deposition of silicone in the form of foreign-body granulomas, also known as siliconomas, is a rare complication of breast implant rupture, which is thought to result from silicone lymphatic or hematogenous migration. In the setting of breast cancer, excluding recurrence should be a priority. While there is no standardised therapeutic approach, implant removal can be an option.
我们报告了一例40多岁晚期女性病例，她有乳腺癌治疗后进行乳房植入手术的病史。她出现乳房不对称增大、可触及对侧腋窝淋巴结以及双侧前臂皮肤结节。此外，影像学评估显示囊内植入物破裂、同侧内乳淋巴结肿大以及多个纵隔淋巴结病变。皮肤和腋窝淋巴结活检显示与硅胶相关的慢性肉芽肿反应及异物巨细胞。乳房植入物手术切除后，皮肤结节消失，所有淋巴结尺寸减小。硅胶以异物肉芽肿形式的全身沉积，也称为硅瘤，是乳房植入物破裂的一种罕见并发症，被认为是由硅胶淋巴或血行迁移导致的。在乳腺癌的情况下，排除复发应是首要任务。虽然没有标准化的治疗方法，但取出植入物可以是一种选择。
