Silicon Embolization Syndrome - A Diagnostic and Therapeutic Dilemma: A Case Series and Review of the Literature

Abstract

In scientific literature, silicone embolization syndrome has been well described and multiple presentations have been delineated. The use of non-medical injections of silicone has become very popular with the public in general, in particular with certain groups that are highly focused on their physical image. Local effects including tissue necrosis, foreign body giant cell reaction, and community-acquired infection have been commonly recorded. Distal effects suggesting an embolic phenomenon can present as regional lymphadenopathy, granulomatous hepatitis, interstitial nephritis, and other acute systemic illnesses. But pulmonary and neurologic sequelae especially warrant emergency attention and can be fatal, if not identified immediately. Pulmonary manifestation can sometimes easily mimic bilateral pneumonia, especially if there is no suspicion for illicit silicone use, which was the case with our patients. The injected subcutaneous silicone migrated rapidly from the interstitial subcutaneous tissue into the general bloodstream resulting in systemic silicone embolization. An analysis of the presented case in conjunction with a review of the pertinent medical literature, including relevant case reports revealed the common clinicopathological manifestations of silicon embolism.