Abstract
Introduction
Silicone breast implants are widely used for breast augmentation and breast reconstruction
following mastectomy. Implant rupture has specific radiological signs. With the advent
use of new imaging technique such as positron emission tomography (PET) computed tomography
(CT) and magnetic resonance imaging (MRI) of the breast, these signs may simulate
malignancy.
Patients and methods
We retrospectively reviewed four cases of patients with silicon breast implants who
arrive to the mammography clinic for further evaluation of a suspected malignant process
demonstrated on either PET CT or breast MRI.
Results
Two cases were of PET CT performed for routine oncology follow-up of breast cancer.
On both, the PET CT demonstrated multiple-spread benign silicone granulomas manifesting
as multiple masses having an increase fluorodeoxyglucose (FDG) uptake. One case of
a new mass was demonstrated as a suspicious mass on the dynamic sequences on MRI of
the breast. Ultrasound-guided biopsy demonstrated benign tissue response to silicone.
One case demonstrated bilateral ruptured breast implants on breast MRI, as well as
bilateral axillary and mediastinal lymphadenopathy. Eventually, the patient underwent
bronchoscopy for pulmonary workup of dry cough, revealing sarcoidosis.
Conclusion
Silicone granulomas can manifest as masses with suspicious morphology and enhancement
dynamics on breast MRI or with increased FDG uptake on PET CT. The presence of silicone
implants and awareness of the possibility of a rupture and formation of silicone granulomas
may help in facilitating a correct diagnosis.
Keywords
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Article info
Publication history
Published online: September 01, 2010
Accepted:
April 10,
2010
Received:
March 1,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
