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Surg Oncol. 1996 Apr;5(2):93-9.

Chest wall fibromatosis associated with silicone breast implants.

AD, O'Mara JW, Legendre KE, SR, Attinger CE, Montgomery EA.

Department of Orthopedic Surgery, town University Hospital, Washington, DC 20007, USA.

Abstract

Aggressive fibromatosis is a well described locally destructive benign lesion, comprising 0.3% of all solid tumors. Although the chest wall is a common location, this tumour has rarely been associated with breast tissue or breast implants. Herein is only the fourth case described in conjunction with a breast implant and the only case linked to a ruptured silicone implant. This tumour was locally aggressive and required wide surgical resection, including removal of the chest wall, to gain control. Wide surgical resection is recommended with the application of adjuvant radiation therapy being more controversial.

PMID: 8853244 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/8853244

J Clin Oncol. 2003 Jun 1;21(11):2216-8.

Unusual problems in breast cancer and a rare lung cancer case. Case 2. Aggressive fibromatosis of the chest wall arising near a breast prosthesis.

Khanfir K, Guinebretiere JM, Vanel D, Barreau-Pouhaer L, Bonvalot S, Le Cesne A.

Institut Gustave Roussy, Villejuif, France.

PMID: 12775750 [PubMed - indexed for MEDLINE

Hum...wonder why the abstract it is gone now ?

oh well, the title says it all...

http://www.ncbi.nlm.nih.gov/pubmed/12775750

Chest wall fibromatosis after mammary prosthesis implantation. A case report and review of the literature].

[Article in Italian]

Gandolfo L, Guglielmino S, Lorenzetti P, Fiducia G, Scenna G, Bosco V.

UO Complessa, Chirurgia Generale 1, Servizio di Day-Hospital e Day-Surgery Azienda Ospedaliera Umberto I, Siracusa.

Abstract

Desmoid tumour of the breast is a rare lesion. Only 9 cases in which the origin of the tumour was linked to a breast implant had been published up to 2004. We report a case of aggressive fibromatosis which developed on the thoracic wall two years after implantation of a mammary prosthesis. This tumour was locally aggressive. Radical surgery is the treatment of choice and in this case required a wide surgical resection, including removal of the chest wall, to gain control. The application of adjuvant radiation therapy is controversial.

PMID: 17069197 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/17069197

Silicone breast implant rupture presenting as bilateral leg nodules.

Sagi L, Baum S, Lyakhovitsky A, Barzilai A, Shpiro D, Trau H, Goldan O, Winkler E.

Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel. lior115@...

Abstract

Gross migration of silicone gel from ruptured breast implants is a rare event. It is associated with extravasation of gel into the breast parenchyma, and to distant locations such as the abdominal wall and inguinal areas. This silicone deposits present as subcutaneous nodules and cause a local reaction known as siliconoma. We evaluated a 56-year-old woman who presented with a 2-year history of painful, firm and ill-defined subcutaneous nodules on the medial aspect of the shins and ankles. Her medical history was notable for bilateral breast augmentation with silicone implants 30 years before presentation. Although there were no signs or symptoms on breast examination, ultrasonography and magnetic resonance imaging confirmed that both implants had ruptured. Histological examination of a punch biopsy from a nodule on the shin found lobular granulomatous panniculitis. An excisional biopsy of the lesion was analysed by scanning electron microscopy and was found to contain silicone. This is a rare case of gross migration of silicone to the shins, originating from ruptured breast implants. To our knowledge, there is no previous report of silicone migration to such a distant location. We discuss the common presentation of silicone migration and highlight the importance of awareness among dermatologists and plastic surgeons about this unusual occurrence.

PMID: 19438562 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19438562

They just think it is rare.......I have shin nodules myself......just not the money to

have them removed....I have had a massive silicone rupture.....I bet there are many many people with the same.......

Breast J. 2009 Sep-Oct;15(5):496-9. Epub 2009 Jul 13.

Intrapulmonary and cutaneous siliconomas after silent silicone breast implant failure.

Dragu A, Theegarten D, Bach AD, Polykandriotis E, Arkudas A, Kneser U, Horch RE, Ingianni G.

Department of Plastic and Hand Surgery, University of Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany. adrian.dragu@...

Abstract

Since the implementation and use of silicone implants in breast surgery the risks are published and discussed. Especially, the incidence of late silicone implant rupture and its potential risk to induce local siliconomas are still under discussion and not sufficiently evaluated. So far literature data offer no information of intrapulmonal or peripheral located cutaneous siliconomas because of systemic migration of silicone after breast augmentation. In light of silicones checkered history, and given the large and growing number of women who choose to undergo breast augmentation surgery each year, the presented clinical findings in our study are likely to be of interest to medical professionals, producers, and consumers alike. We present six female patients with an average age of 55 (+/-5) years with bilateral rupture of silicone implants after breast augmentation for aesthetic reasons. The average time after operation was 18 (+/-6) years. In five patients, we identified peripheral located cutaneous siliconomas and one patient suffered from an intrapulmonal siliconoma. The diagnosis of bilateral rupture of the silicone implants was performed preoperatively by MRI-scans. All five peripheral cutaneous siliconomas and the intrapulmonal siliconoma were validated by histopathologic analysis. Six female patients suffered from bilateral rupture of silicone implants after breast augmentation. In five patients, we identified peripheral located cutaneous siliconomas which were surgically excised. One patient suffered from an intrapulmonal siliconoma. In this unique case a lobectomy with resection of the pulmonal segment 10 had to be performed. Clinical findings of peripheral cutaneous and even intrapulmonary siliconomas after bilateral rupture of silicone breast implants indicate a systemic hematogen or lymphatic pathway of silicone. These findings suggest that it is mandatory to inform the patient about the potential risk of local siliconomas, but also about the potential risk of peripheral cutaneous or even intrapulmonary siliconomas caused by systemic hematogen or lymphatic pathways of silicone after silent implant failure.

PMID: 19624416 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19624416

Handchir Mikrochir Plast Chir. 2006 Aug;38(4):224-32.

[Histological and immunohistochemical investigations with capsular contracture after breast augmentation with smooth silicone gel implants].

[Article in German]

Prantl L, Schreml S, Fichtner-l S, Pöppl N, Roll C, Eisenmann-Klein M, Hofstädter F.

Klinik für Plastische Chirurgie, Universitätsklinikum Regensburg. lukas.prantl@...

Abstract

INTRODUCTION: A prospective study was performed to analyse the cellular and molecular composition of fibrous capsules around silicone breast implants. The necessity of an exact histological classification for comparing objectively the different findings of capsular contracture is shown.

PATIENTS AND METHODS: The prospective study (investigation time 1/2003 to 6/2005) included 24 female patients (average age: 40+/-12 years) with contracture after bilateral cosmetic breast augmentation with smooth silicone gel implants (Mentor). In each patient the baker score was determined preoperatively. Samples of capsular tissue from all patients were evaluated histologically and immunohistochemically and classified according to the histological classification introduced by Wilflingseder and co-workers.

RESULTS: All capsules showed the same basic histological structure with a three-layer composition. For the correlation analysis we had to exclude one patient with repeated implant change. There was no correlation between the patient's age, time of implantation, length of implant period, and capsular contracture. Greater amounts of silicone particles were associated with increased degrees of capsular contracture (Baker: r = 0.687, n = 23, p < or = 0.001; Wilflingseder: r = 0.784, n = 23, p < or = 0.001). High silicone amounts were associated with an increased local inflammation (r = 0.489, n = 23, p , 0.05). A moderate to severe local inflammation was found in 23 patients (95.8%). In summary, there was a positive correlation (r = 0.797, n = 23; p , or = 0.001) between the clinical classification (Baker score I to IV) and the histological classification (Wilflingseder score I to IV).

CONCLUSIONS: We demonstrated in our study, in spite of using implants with high gel cohesiveness (fourth generation), the presence of vacuolated macrophages with microcystic structures containing silicone and silicone particles in the capsular tissue. Greater capsular thickness was associated with an increased number of silicone particles ans silicone-loaded macrophages in the peri-implant capsule. The histological classification introduced by Wilflingseder and co-workers takes into consideration this pathogenetic mechanism of inflammatory reaction which seems to be one of the major key factors in the development of capsular contracture.

PMID: 16991042 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/16991042

Severe migratory granulomatous reactions to silicone gel in 3 patients.

Teuber SS, Reilly DA, Howell L, Oide C, Gershwin ME.

Veterans Affairs Northern California Health Care System, Pleasant Hill, USA. steuber@...

Abstract

In humans implanted with silicone gel breast prostheses, a mild foreign body response results in the formation of a collagenous capsule around the prosthesis. Although many such patients may show evidence of a microscopic granulomatous foreign body reaction upon examination of capsular material at explantation of a prosthesis, it is unusual to have large, palpable granulomas, even in the presence of rupture or leakage. Rare patients have had severe local inflammation and complications resulting from silicone migration to the axilla, arm, or abdominal wall. We describe 3 patients who had deforming granulomas after implant rupture, along with other consequences of silicone gel migrating down the upper extremity. Silicone gel, once it leaves the implant, is not biologically inert and in some persons can elicit profound pathologic responses.

PMID: 10090186 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/10090186

J Plast Reconstr Aesthet Surg. 2006;59(8):885-6. Epub 2006 Feb 20.

Locoregional silicone spread after high cohesive gel silicone implant rupture.

Lahiri A, Waters R.

Selly Oak Hospital, University Hospitals Birmingham, Raddlebarn Road, Birmingham B29 6JD, UK. anindyalahiri@...

Comment in:

J Plast Reconstr Aesthet Surg. 2007;60(10):1166-7.

J Plast Reconstr Aesthet Surg. 2007;60(8):967-8.

Abstract

A 45-year-old patient had routine cosmetic bilateral breast augmentation 6 years previously using cohesive gel implants. She presented 4 years later with a breast lump and multiple axillary lymph nodes. Exploration revealed that the breast implant had a large tear at the posterior wall of the shell with intra-capsular leakage of silicone. The axilla had eight enlarged lymph node--all were removed. Histology showed silicone granuloma in the capsule and silicone lymphadenitis. High cohesive gel implants may not be as safe as is commonly believed and all implant ruptures, irrespective of the cohesiveness of the silicone gel, should be investigated thoroughly.

PMID: 16876092 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/16876092

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overcomes the love of power

the world will know peace.

~ Jimi Hendrix