Silicone-induced granuloma of breast implant capsule mistaken for breast implant-associated anaplastic large cell lymphoma

Abstract

For patients with breast implants who present with an isolated seroma, capsular contracture, or peri-implant mass, clinicians must rule out breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). As non-malignant silicone-induced granuloma of breast implant capsule (SIGBIC) may mimic BIA-ALCL, particular care must be exercised to prevent misdiagnosis. In this report, we describe three cases of SIGBIC misdiagnosed as BIA-ALCL. In each of these cases, a preoperative evaluation including breast magnetic resonance imaging and physical examination, as well as the fact that a textured silicone implant was used in the patients, indicated a high probability of malignancy. In all three cases, however, an explorative operation and pathologic results revealed foreign body granulomas without malignant features. While it is critical that potential cases of BIA-ALCL be diagnosed and treated quickly, hasty judgments may lead to misdiagnosis and severe emotional distress in patients. Increased awareness of SIGBIC, specifically its mimicry of BIA-ALCL, may be helpful to avoid these outcomes.