Silicone granulomas

Clinical:

  • A 45 years old lady
  • Came for screening mammogram
  • Asymptomatic
  • No family history of breast cancer
  • History of free-silicone injection for breast augmentation many years before
Mammogram in MLO view
Mammogram in CC view

Mammogram findings:

  • There are bilateral and multiple high density opacities in both breasts
  • These opacities are of various sizes and shapes
  • It causes obliteration of the normal breast tissue shadows
  • No obvious distortion of shape is seen
  • No nipple retraction or skin thickening

Diagnosis: Silicone granulomas/siliconomas.

Discussion:

  • Direct injection of free silicone into the breast has been prohibited by US FDA in the 1970s due to its many adverse effects.
  • However, in our country it is performed illegally mainly by non-trained personnel.
  • The dverse effects of this injection included lymphadenopathy, infection, formation of granulomatous masses (siliconoma), and fibrosis.
  • The resulting nodularity of this silicone mastopathy made it difficult to differentiate fibrous silicone breast masses from carcinoma at physical examination because both may manifest as a palpable mass.
  • At mammography, these silicone globules appear as multiple radiopaque globules, some with a rim of calcification, which distort the breast parenchyma.
  • It presents a dilemma for the radiologist because it interferes with the interpretation of mammographic findings and can easily obscure breast carcinoma.

 

 

 

Author: radhianahassan