<p>Adverse reaction regarding titanium-based marker clip: case report of a potential complication</p>

Abstract

Adverse reaction to titanium-based breast marker clip is a very uncommon complication in medicine. We report a 65-year-old female patient who was referred with left breast lumpiness to the assessment clinic. Breast radiology with interesting sequelae following titanium clip insertion, in combination with literature review, will be discussed. The patient had a history of adverse skin reactions to base metals. However, no allergy specifically to titanium was reported. Imaging findings with regard to the symptomatic breast were nonspecific; thus, multiple core biopsies were taken, and titanium clip was inserted. Subsequent histological examination showed benign changes. However, 7 weeks later, the marked area became very tender and the same patient re-presented to the clinic, requesting removal of the metallic component. Following multidisciplinary meetings and discussions, the person underwent ultrasound-guided vacuum biopsy and the clip was removed. The symptoms completely resolved after the successful procedure, and histological examination revealed lymphocytic infiltration of the tissues. Reactions to titanium-based marker clips are rare and only limited records have been found in the literature. More cases need to be reported in order to establish the full significance of such adverse sequelae. It is recommended that medical history with regard to allergies, prior titanium clip insertions, should be discussed.

An unusual case of huge fibrotic sac of hematoma at saphenous vein harvest site for coronary artery bypass grafting: a case report

“…If the mass had been simply aspirated percutaneously, it would be more likely to recur. There are some reports of titanium inducing foreign body reactions such as inflammation and fibrosis [ 16 , 17 ], but the probability is very low. So, it is not known with certainty why the large hematoma and the fibrotic sac emerged, as there is no definitive evidence to support their occurrence, only speculation.…”

Long-term safety and efficacy of breast biopsy markers in clinical practice

“…The presence of titanium in biopsy markers raises the possibility of allergic reactions during or after placements. A 2019 case report by Wegner et al [12] highlights an allergic reaction to HydroMARK titanium-based biopsy marker in a patient who presented with pain, discomfort, and itching. To investigate the possibility of allergic reactions to titanium-based biopsy markers, we excluded patients who have had a hypersensitivity or an immune response to bovine products, collagen, and/or collagen products.…”

“…Reports of AEs have been mostly centered on marker migration/ displacement, disappearance, and allergic reactions [4,[6][7][8][9][10][11]. Most of the studies done to evaluate adverse effects involved smaller sample sizes and case reports [11,12]. To our knowledge, no study in the literature has gone beyond device-related adverse effects to investigate device deficiencies (DD) or malfunction.…”

Indications for Interventional Procedures of the Breasts and Axillae

“…Također je nužno da je bolesnik u mogućnosti pridržavati se uputstva kojim se sprječavaju postbiopsijske komplikacije te da je suglasan s postbiopsijskim slikovnim odnosno kirurškim kontrolnim pregledima. Iako se tradicionalno preporučuje poseban oprez kod bolesnika koji uzimaju antikoagulantnu terapiju, sve više je studija koje potvrđuju da rizik za postbiopsijske komplikacije nije značajno viši prilikom uzimanja ove terapije 12 . Na dan biopsije preporučuje se mirovanje i izbjegavanje težih napora.…”