Syndrome of Inappropriate Antidiuretic Hormone and Silicone Lymphadenopathy After Breast Reconstruction

Zeman, J.; Fiacco, Nicholas R.; Cooper, Barbara Acheson

doi:10.1378/chest.2278009

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This case is only the second one described in the literature. The abstract published by Joseph Zeman (Lung Cancer, 2015 2 ) reports on a 64-year-old woman with severe hyponatremia after bilateral prophylactic mastectomy and reconstruction with breast implants. The computed tomography demonstrated ruptured breast implants as well as bilateral axillary lymphadenopathy, internal mammary chain lymph nodes, and small pulmonary nodes.…”

Section: Discussionmentioning

confidence: 99%

“…1 The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is paraneoplastic and has so far been described only once as a consequence of ruptured silicone implants. 2 The pathophysiology involves a continued secretion or action of arginine vasopressin despite a normal or increased plasma volume, resulting in impaired water excretion. 3 SIADH is caused by inappropriate hypersecretion of antidiuretic harmone from the hypothalamus, or by an ectopic production by a tumor.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Successful Treatment of SIADH after Removal of Ruptured Breast Implants

Thuerlimann,

Morel,

Martin

et al. 2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: Local adverse reactions to breast implants and systemic reactions, mostly autoinflammatory, are numerously described in the literature. A patient presented at our institution with severe neurologic symptoms, including confusion and phasic troubles due to severe hyponatremia as part of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Common etiologies for SIADH, primarily malignancy and central nervous system disturbances, have been ruled out by imaging. On the computed tomography scan of the thorax and abdomen, several masses were found in the pectoral region, inferior to the sternum and in the left axilla that were biopsied and verified as silicone. While evaluating the patient’s medical history, the patient remembered having undergone breast augmentation with silicone implants several decades ago. The only explanation left for the persisting SIADH was her ruptured silicone implants, causing an inflammatory systemic reaction. Literature was searched, and one abstract was found, in which a woman presenting with SIADH was treated successfully after removal of her silicone breast implants. We offered the same treatment to our patient, and siliconomas were removed through a bilateral inframammary approach as well as axillary on the left. There were no complications encountered. Postoperatively, the patient’s hyponatremia improved and normalized 1 month later even without hydric restriction. This potential form of etiology and treatment of SIADH is a novelty in the medical literature. Surgical removal of dispersed silicone is presumed to be the cure for this syndrome. It represents a diagnosis of exclusion after more life-threatening causes, such as central nervous system disturbances and malignancies, have been ruled out.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%