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Silicone Granuloma
Melissa Durand, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Silicone-induced granuloma of breast implant capsule (SIGBIC) due to gel bleed from intact implant
          • Definitions

            • Silicone granuloma = siliconoma: Inflammatory mass caused by foreign body reaction to silicone gel in tissue; result of extracapsular rupture, gel bleed, or free injection

          IMAGING

          • General Features

            • Mammographic Findings

              • Ultrasonographic Findings

                • Nuclear Medicine Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Seynnaeve C and Berg WA: Intraductal extracapsular rupture of silicone breast implant. Annals Clin Case Reports. 2:1369-70, 2017
                                    2. de Faria Castro Fleury E et al: Breast magnetic resonance imaging: tips for the diagnosis of silicone-induced granuloma of a breast implant capsule (SIGBIC). Insights Imaging. 8(4):439-446, 2017
                                    3. Seiler SJ et al: Multimodality imaging-based evaluation of single-lumen silicone breast implants for rupture. Radiographics. 37(2):366-382, 2017
                                    4. Zambacos GJ et al: Silicone lymphadenopathy after breast augmentation: case reports, review of the literature, and current thoughts. Aesthetic Plast Surg. 37(2):278-89, 2013
                                    5. DiCarlo CM et al: Pleural silicone granuloma mimics pleural metastasis: Ruptured breast implant with silicone fistulising along a remote thoracotomy scar. Radiol Case Rep. 7(3):672, 2012
                                    6. Shepherd SM et al: Silicone granuloma mimicking breast cancer recurrence on PET CT. Breast J. 16(5):551-3, 2010
                                    7. Berg WA et al: MR imaging of extracapsular silicone from breast implants: diagnostic pitfalls. AJR Am J Roentgenol. 178(2):465-72, 2002
                                    8. Brown SL et al: Silicone gel breast implant rupture, extracapsular silicone, and health status in a population of women. J Rheumatol. 28(5):996-1003, 2001
                                    9. Caskey CI et al: Imaging spectrum of extracapsular silicone: correlation of US, MR imaging, mammographic, and histopathologic findings. Radiographics. 19 Spec No:S39-51; quiz S261-2, 1999
                                    10. Kulber DA et al: Monitoring the axilla in patients with silicone gel implants. Ann Plast Surg. 35(6):580-4, 1995
                                    11. Harris KM et al: Silicone implant rupture: detection with US. Radiology. 187(3):761-8, 1993
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Silicone-induced granuloma of breast implant capsule (SIGBIC) due to gel bleed from intact implant
                                            • Definitions

                                              • Silicone granuloma = siliconoma: Inflammatory mass caused by foreign body reaction to silicone gel in tissue; result of extracapsular rupture, gel bleed, or free injection

                                            IMAGING

                                            • General Features

                                              • Mammographic Findings

                                                • Ultrasonographic Findings

                                                  • Nuclear Medicine Findings

                                                    • MR Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Seynnaeve C and Berg WA: Intraductal extracapsular rupture of silicone breast implant. Annals Clin Case Reports. 2:1369-70, 2017
                                                                      2. de Faria Castro Fleury E et al: Breast magnetic resonance imaging: tips for the diagnosis of silicone-induced granuloma of a breast implant capsule (SIGBIC). Insights Imaging. 8(4):439-446, 2017
                                                                      3. Seiler SJ et al: Multimodality imaging-based evaluation of single-lumen silicone breast implants for rupture. Radiographics. 37(2):366-382, 2017
                                                                      4. Zambacos GJ et al: Silicone lymphadenopathy after breast augmentation: case reports, review of the literature, and current thoughts. Aesthetic Plast Surg. 37(2):278-89, 2013
                                                                      5. DiCarlo CM et al: Pleural silicone granuloma mimics pleural metastasis: Ruptured breast implant with silicone fistulising along a remote thoracotomy scar. Radiol Case Rep. 7(3):672, 2012
                                                                      6. Shepherd SM et al: Silicone granuloma mimicking breast cancer recurrence on PET CT. Breast J. 16(5):551-3, 2010
                                                                      7. Berg WA et al: MR imaging of extracapsular silicone from breast implants: diagnostic pitfalls. AJR Am J Roentgenol. 178(2):465-72, 2002
                                                                      8. Brown SL et al: Silicone gel breast implant rupture, extracapsular silicone, and health status in a population of women. J Rheumatol. 28(5):996-1003, 2001
                                                                      9. Caskey CI et al: Imaging spectrum of extracapsular silicone: correlation of US, MR imaging, mammographic, and histopathologic findings. Radiographics. 19 Spec No:S39-51; quiz S261-2, 1999
                                                                      10. Kulber DA et al: Monitoring the axilla in patients with silicone gel implants. Ann Plast Surg. 35(6):580-4, 1995
                                                                      11. Harris KM et al: Silicone implant rupture: detection with US. Radiology. 187(3):761-8, 1993