Hepatic infiltration by silicone in a patient With ASIA syndrome

Abstract

A utoimmune/inflammatory syndrome induced by adjuvants (ASIA) is frequently characterized by myalgias, myositis, arthralgia, neurological manifestations, fever, dry mouth, and cognitive alterations. (1) In the range of clinical conditions related to ASIA syndrome, siliconosis after breast implants has been reported. (1) Here, we report a case of hepatic infiltration by silicone in a patient with ASIA syndrome.

Hepatic Silicone Granulomas Secondary to Ruptured Breast Implants: A Report of Two Cases

“…Other tissues showed droplets of elemental silicone or plaques composed of elemental silicone and titanium, either deposited directly in the tissue or located within the lumen of blood vessels [8]. Silicone breast implants have also been reported to induce autoimmune/inflammatory syndromes including ASIA syndrome (autoimmune/inflammatory syndrome induced by adjuvants) [2, 6, 9].…”

“…One biopsy showed an associated chronic active hepatitis with nodular fibrosis, while the other showed fine scarring with partial nodule formation and no associated inflammation [3]. In the report of a case of hepatic silicone granulomas with associated ASIA syndrome secondary to breast implant rupture, the liver biopsy showed portal tracts expanded by foamy multivacuolated material, rare granulomas, and vacuolated material within lobular macrophages [2].…”

“…Only two prior publications in the English literature describe the histologic findings of unsuspected silicone granulomas in liver biopsies performed for elevated liver enzymes. One case was associated with a ruptured breast implant, and two cases were associated with hemodialysis-related silica exposure [2, 3]. We report two cases of silicone granulomas discovered on liver biopsy in patients with a history of ruptured breast implants, who were referred to gastroenterology specialists for evaluation of isolated elevated alkaline phosphatase levels.…”

Hepatobiliary complications from ruptured silicone breast implants – a comprehensive literature review

“…The search strategy revealed paucity of literature in the research topic, with 3 papers (4 case reports) describing hepatobiliary complications after ruptured silicone breast implants [ 7 ], [ 8 ], [ 9 ]. A paper by Tan et al (titled: hepatobiliary complications following breast implants: a case report and literature review) was excluded, as the paper has since been retracted from literature by the time the authors of this paper finished writing.…”

“…The mean age in years at the time of presentation was 50 (range:38–58). Information about ethnicity was available in all the papers: 3 Caucasians [ 8 ], [ 9 ]; and 1 Hispanic [ 7 ].…”