Mirror, mirror on the wall: Hypercalcemia as a consequence of modern cosmetic treatment with liquid silicone

Abstract

SummaryBackgroundHypercalcemia is a common problem in clinical practice and can be related to endocrine disorders or malignant disease, especially in elderly patients. Although rare, other causes can also be responsible.Case ReportGranulomatous inflammation of the skin and lymph nodes induced by intravenous or injectable silicone is a rare condition of hypercalcemia that is usually not within the scope of differential diagnosis. Here, we report a 72-year-old woman with symptomatic hypercalcemia related to cosmetic treatment of the neck. Topical applied liquid silicone by means of a focal ultrasound device induced extensive granulomatous inflammation of the skin and local lymph nodes, being the underlying cause for hypercalcemia in this case.ConclusionsIn rare cases, symptomatic hypercalcemia can be caused by silicone due to a severe granulomatous tissue reaction. This is the first time that a transdermal silicone treatment has been reported to cause severe granulomatous tissue inflammation.

Silicone-Induced Granuloma after Injection for Cosmetic Purposes: A Rare Entity of Calcitriol-Mediated Hypercalcemia

“…An extensive search of the literature revealed three reported cases of hypercalcemia secondary to silicone injections for cosmetic reasons [ 7 – 9 ]. Silicone-induced hypercalcemia has also been reported in two dialysis patients secondary to the silicone content of their dialysis tubing, which resolved when these lines were replaced by silicone-free material [ 10 ].…”

Silicone-Induced Granulomatous Reaction Causing Severe Hypercalcemia: Case Report and Literature Review

“…In only one case, SBI was identified as the sole cause of hypercalcemia [10]. Also reported was the use of silicone with the help of transdermal ultrasound to remove wrinkles from the face and neck in one of the cases [5]. Hydration and steroids, with or without bisphosphonates, were the mainstay of treatment, but with improvement in only five cases [3, 5, 6, 12, 13].…”

“…Also reported was the use of silicone with the help of transdermal ultrasound to remove wrinkles from the face and neck in one of the cases [5]. Hydration and steroids, with or without bisphosphonates, were the mainstay of treatment, but with improvement in only five cases [3, 5, 6, 12, 13]. Surgical excision of silicone granulomas helped normalize serum calcium in two of the reported cases, [9] and removal of breast implants resulted in improvement in one case [10].…”

ASIA syndrome, calcinosis cutis and chronic kidney disease following silicone injections. A case-based review

“…The association between silicone injection, granulomas and hypercalcemia has been reported since 1984 [58], and there are several reports in the literature [59][60][61][62]. As for the other granulomatous diseases, hypercalcemia is likely the consequence of a dysregulated production of 1,25-dihydroxivitamin D by activated macrophages (induced by tumor necrosis factor-a and interferon-c, and inhibited by corticosteroids) [63] and/or an increase of PTHrP levels (stimulated by TNF-a and IL-6) [64].…”