Axillary Silicone Laden Lymph Nodes: an Unusual Cause of Lymphadenopathy Case Report
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SURGERY
Axillary Silicone Laden Lymph Nodes: an Unusual Cause of Lymphadenopathy Case Report Yolunna Mekkam 1 & Elizabeth Imperial 1 & Zubir Rentiya 2 & James Kang 1 & Chris Elsayad 1 & Anjum Maqbool 1 & Vilma Vas 1 Accepted: 9 November 2020 / Published online: 16 November 2020 # Springer Nature Switzerland AG 2020
Abstract Breast augmentation surgery is one of the most common cosmetic surgeries in the world. The surgery has several complications with implant rupture and deflation being some of the more common ones. We report a case of silicone laden lymph nodes 13 years after breast augmentation. The silicone laden lymph nodes resulted in bilateral breast pain and itching for several months. Findings of the silicone lymphadenopathy were discovered using ultrasound which revealed mild lobulation of the anterior left implant capsule with several punctate densities adjacent to the capsule potentially indicating implant rupture. Ultrasound of the right axilla showed lymph nodes with similar echogenicity of the silicone implant. Snowstorm appearance was also noted indicating silicone laden lymph nodes and potential extracapsular rupture which was confirmed with MRI. The intention of this case report is to bring awareness to one of the several possible complications of breast augmentation and to potentially use its presence to warrant further investigation of other breast implant rupture complications. Keywords Silicone lymphadenopathy . Breast . Implant . Axilla . Rupture
Introduction Breast augmentation is one of the most common cosmetic procedures in the USA [1]. First performed in 1964, there This article is part of the Topical Collection on Surgery * Vilma Vas [email protected] Yolunna Mekkam [email protected] Elizabeth Imperial [email protected] Zubir Rentiya [email protected] James Kang [email protected] Chris Elsayad [email protected] Anjum Maqbool [email protected] 1
Nassau University Medical Center, East Meadow, NY, USA
2
Johns Hopkins University School of Medicine, Baltimore, MD, USA
have been many advances in the field of breast implants. Notably, newer generation silicone implants have since remained a widely used material due to its nonbiodegradable quality, natural feel, and its decreased incidence of capsular contracture compared to its older counterparts [2]. Although silicone has been thought previously as inert within the human body, there have been reported cases of transmission of silicone into adjacent lymph nodes. Many breast implant ruptures are silent and go undetected for years preventing the early detection of lymph node abnormalities. Magnetic resonance imaging has made the detection of such silent ruptures readily and reliably detectable. [3]. We report a case of axillary silicone lymphadenopathy 13 years after bilateral breast augmentation.
Case Report A 59-year-old woman presented to the primary care clinic with pain and itchiness in both breasts for several months that worsened at night. Her past surgical history is notable for bilateral
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