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Silicone Granuloma

Siliconomas


Presentation

  • Here we present an unusual clinical presentation of a silicone granuloma in a patient with a 27-year history of a wide excision of a melanoma of the right lower extremity and subsequent soft-tissue reconstruction using a silicone device.[ncbi.nlm.nih.gov]
  • We present a case of debilitating silicone granuloma of the penis and scrotum secondary to large-volume injections into the corpora cavernosae and penile soft tissues administered in Belgium 14 years prior to presentation.[ncbi.nlm.nih.gov]
  • We present a 43-year-old woman with a severely disfiguring facial silicone granuloma who was successfully treated with minocycline.[ncbi.nlm.nih.gov]
  • Here we present a case of an 87-year-old woman who had undergone bilateral breast augmentation with silicone injections in her youth. Although she became aware of a tumor in her right breast, she waited 8 years before seeking treatment.[ncbi.nlm.nih.gov]
  • Abstract A 56-year-old woman with a 10-year history of bilateral silicone breast implants presented to the ear, nose and throat outpatient clinic with a 2-month history of a right-sided neck lump.[ncbi.nlm.nih.gov]
Cervical Lymphadenopathy
  • KEYWORDS: Breast implants; Cervical lymphadenopathy; Otolaryngology; Silicone granuloma[ncbi.nlm.nih.gov]
  • In addition, CT studies also detected a significant increase of non-cervical lymphadenopathies in 8 patients, mainly axillary.[elsevier.es]
Raynaud Phenomenon
  • In February 1993, she noticed edema of her distal phalanges, Raynaud's phenomenon in both hands, flu-like symptoms, fatigue, intermittent diarrhea, abdominal pain, tearing in both eyes, dyspnea on exertion, dysphagia, and odynophagia.[ncbi.nlm.nih.gov]
Amyloidosis
  • "Amyloidosis and silicone synovitis: Updated classification, updated pathophysiology, and synovial articular abnormalities". Radiologic Clinics of North America. 34 (2): 375–94, xi. PMID 8633122.[en.wikipedia.org]
Aspiration
  • Ultrasonography guided fine needle aspiration was inconclusive and initial review of subsequent computed tomography failed to identify a cause.[ncbi.nlm.nih.gov]
  • RESULTS: In a 10-year period, we identified 12 cases with silicone-infiltrated neck lymphadenopathies, histologically confirmed by fine needle aspiration. They represented 3.5% of patients attended for neck lymph node study.[ncbi.nlm.nih.gov]
  • Fine needle aspiration cytology (FNAC) was conducted for palpable lesions in both breasts and confirmed to be granulomatous reaction secondary to intramammary silicone injection.[casereports.bmj.com]
  • Results In a 10-year period, we identified 12 cases with silicone-infiltrated neck lymphadenopathies, histologically confirmed by fine needle aspiration. They represented 3.5% of patients attended for neck lymph node study.[elsevier.es]
Abdominal Pain
  • In February 1993, she noticed edema of her distal phalanges, Raynaud's phenomenon in both hands, flu-like symptoms, fatigue, intermittent diarrhea, abdominal pain, tearing in both eyes, dyspnea on exertion, dysphagia, and odynophagia.[ncbi.nlm.nih.gov]
Diarrhea
  • In February 1993, she noticed edema of her distal phalanges, Raynaud's phenomenon in both hands, flu-like symptoms, fatigue, intermittent diarrhea, abdominal pain, tearing in both eyes, dyspnea on exertion, dysphagia, and odynophagia.[ncbi.nlm.nih.gov]
Odynophagia
  • In February 1993, she noticed edema of her distal phalanges, Raynaud's phenomenon in both hands, flu-like symptoms, fatigue, intermittent diarrhea, abdominal pain, tearing in both eyes, dyspnea on exertion, dysphagia, and odynophagia.[ncbi.nlm.nih.gov]
Dysphagia
  • In February 1993, she noticed edema of her distal phalanges, Raynaud's phenomenon in both hands, flu-like symptoms, fatigue, intermittent diarrhea, abdominal pain, tearing in both eyes, dyspnea on exertion, dysphagia, and odynophagia.[ncbi.nlm.nih.gov]
Pruritic Rash
  • Report of a Case A 25-year-old Caucasian female presented with a 6-month history of a mildly pruritic rash of the radial wrists, left medial knee and dorsal feet.[avensonline.org]

Workup

Granulomatous Tissue
  • Pathology results confirmed granulomatous tissue without malignancy. There were no postoperative complications and the patient was discharged after five days in the hospital.[jcasonline.com]

Treatment

  • The development of a silicone foreign body reaction, massive edema, and subsequent impotence lends itself to a clinical diagnosis and aggressive treatment with wide local excision and appropriate soft-tissue coverage.[ncbi.nlm.nih.gov]
  • […] illness treatments as well.[gotpummped.wordpress.com]
  • Treatment of siliconomas is difficult and granulomas involving the face are a therapeutic challenge. We present a 43-year-old woman with a severely disfiguring facial silicone granuloma who was successfully treated with minocycline.[ncbi.nlm.nih.gov]
  • The refractory silicone granuloma responded dramatically to treatment with etanercept.[ncbi.nlm.nih.gov]
  • Although she became aware of a tumor in her right breast, she waited 8 years before seeking treatment. She felt the tumor growing and experienced swelling and pain, but she ended up declining therapy at that time.[ncbi.nlm.nih.gov]

Prognosis

  • The disease has a relatively higher occurrence among young people, and its prognosis (3-year-survival of only 38%) is extremely poor compared to breast cancer.[ncbi.nlm.nih.gov]

Etiology

  • The extent of lymphocytic cuffing was more extensive than typically observed in sarcoidosis, but pathology alone could not rule out sarcoidosis or an infectious etiology.[avensonline.org]
  • […] mammoplasty and joint prostheses ( Hum Pathol 1980;11:240 ) Once released into tissue, silicone migrates to distant sites through lymphatic channels and bloodstream Once it reaches lymph nodes, it elicits a reaction and cause silicone lymphadenopathy Etiology[pathologyoutlines.com]

Pathophysiology

  • "Amyloidosis and silicone synovitis: Updated classification, updated pathophysiology, and synovial articular abnormalities". Radiologic Clinics of North America. 34 (2): 375–94, xi. PMID 8633122.[en.wikipedia.org]
  • Understanding their pathophysiology is essential in differential diagnosis and appropriate management.[aestheticsjournal.com]
  • […] enlargement of regional lymph nodes caused by the presence of silicone carried from tributary organs Either an incidental finding or causes painful / enlarged lymph node May be associated with granulomatous inflammation ( Histol Histopathol 1997;12:1003 ) Pathophysiology[pathologyoutlines.com]

Prevention

  • Thick sections (10-30 micrometer thick) prevent loss of silicone droplets during tissue processing. The silicones can be detected by adding stamp pad ink to the mounting medium.[histopathology-india.net]
  • It is used to prevent and treat acute attacks of malaria. It is also used to treat discoid or systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments.[gotpummped.wordpress.com]
  • When comparing with other causes of implant rupture, CSG potentially damaging effect may most likely only play a minor role in implant rupture but is surgically preventable.[pubs.sciepub.com]
  • Counselling the patient and adopting preventative measures such appropriate filler choice and prevention of infection should be part of every case of dermal filler injections.[aestheticsjournal.com]
  • After only a few years, Dow Corning discontinued the project and abandoned efforts to gain FDA approval, claiming that they could not prevent misuse of the product.[jcasonline.com]

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