Disseminated Pleural Siliconoma Mimicking Malignant Pleural Mesothelioma

Our plain-English summary of Disseminated Pleural Siliconoma Mimicking Malignant Pleural Mesothelioma, by T. Tanaka, H. Tao, T. Hayashi, et al (The Annals of Thoracic Surgery, 2015).

The study

• Authors: T. Tanaka, H. Tao, T. Hayashi, K. Yoshiyama, M. Furukawa, K. Yoshida, K. Okabe
• Journal: The Annals of Thoracic Surgery
• Published: 2015;100(6):2339-40
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 48-year-old woman with a 3-month history of back pain was admitted for further examination of multiple left pleural nodules. She had undergone bilateral breast augmentation with silicone implants 10 years previously. Nine years after the operation, both ruptured implants were removed, and autologous fat was injected. Computed tomography revealed multiple pleural nodules suggestive of malignant pleural mesothelioma. Thoracoscopic exploration revealed multiple pleural nodules with massive pleural adhesions. The nodules were filled with viscous liquid and were histologically determined to be siliconomas. Disseminated pleural siliconoma should be recognized as a late adverse event of silicone breast implantation.

Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

In plain English

This case report from a thoracic surgery department in Ube, Japan, described one 48-year-old woman with multiple nodules on the lining of her left lung (the pleura). She had received silicone breast implants 10 years earlier. The implants later ruptured and were removed, and fat from her own body was injected. Afterward she had occasional high fever and then chest and back pain that worsened over 3 months. CT and PET scans were consistent with malignant pleural mesothelioma, but there was no fluid around the lung, which did not fit that diagnosis. Surgeons examined the chest through a thoracoscope. The nodules contained thick liquid and, under the microscope, were siliconomas, a tissue reaction to silicone. Most nodules were removed, but a few near the phrenic and vagal nerves could not be. Her pain resolved. The authors suggested the silicone may have entered the chest directly through the third intercostal space, a gap between ribs. The article does not discuss asbestos. The authors concluded that thoracic surgeons should be aware of this possibility when multiple pleural nodules are found after silicone breast augmentation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 48-year-old woman referred to the Division of Thoracic Surgery, Yamaguchi-Ube Medical Center, Ube, Japan, for multiple left pleural nodules; dates of care not stated
• Exposure: Silicone gel from ruptured silicone breast implants placed 10 years earlier (bilateral breast augmentation); no asbestos exposure is mentioned
• Main results:
  • Chest CT showed multiple left pleural nodules and PET showed uptake in them, which were consistent with malignant pleural mesothelioma
  • The absence of left pleural effusion on CT did not fit that diagnosis, so thoracoscopic exploration was done
  • Removed nodules contained viscous liquid and were diagnosed on histology as siliconoma
  • A few nodules around the phrenic and vagal nerves could not be resected
  • The patient recovered without adverse events after surgery and her chest and back pain resolved
  • The authors suggested the silicone gel may have spread directly through the third intercostal space into the chest cavity
• The authors' conclusion: The authors concluded that the report should make thoracic surgeons aware that disseminated pleural siliconoma is possible when multiple pleural nodules are found after silicone breast augmentation

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Bilateral.

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• Chondrosarcoma of the Rib Mimicking Malignant Pleural Mesothelioma — M. Furukawa, H. Tao, et al. (2016)
• Peritoneal washing cytology findings of disseminated myxoid leiomyosarcoma of uterus: report of a case with emphasis on possible differential diagnosis — W.K. Ng, P.C. Lui, et al. (2002)
• Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for disseminated intra-abdominal malignancies in children-a single-institution experience — O. Zmora, A. Hayes-Jordan, et al. (2018)
• Primary thymic epithelial tumours of the pleura mimicking malignant mesothelioma — R.L. Attanoos, F. Galateau-Salle, et al. (2002)

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