Migration of Silicone Particles Into the Liver Following Rupture of Silicone Breast Implant: A Case Report and Literature Review

TL;DR

This case report describes silicone particles migrating to the liver after a ruptured breast implant and highlights the challenges in diagnosing such rare complications.

Contribution

This is the first reported case of silicone granuloma in the liver following a ruptured breast implant from the UK.

Findings

Silicone granulomas in the liver were incidentally detected via MRI in a patient with a ruptured breast implant.

The patient was asymptomatic and required no treatment for the hepatic lesions.

Silicone migration can mimic metastatic deposits, requiring a multidisciplinary approach for diagnosis and management.

Abstract

Breast augmentation using a silicone implant is a popular procedure. However, there are rare complications being reported in addition to common risks following breast implant insertion. Our aim is to report one of the rare complications, migration of silicone particles into the liver, following rupture of the silicone breast implant. The patient previously had insertion of bilateral silicone breast implants. She was presented with pain and swelling of the left breast for which she had mammograms, ultrasound scans of the breasts, and magnetic resonance imaging (MRI) of the breasts. They identified rupture of the silicone implant on the left side and incidentally detected silicone granulomas in the liver on an MRI scan of the breasts. These hepatic lesions were then confirmed by a CT scan of the liver. She underwent the removal of bilateral breast implants. However, she was asymptomatic of hepatic silicone granulomas, and no further treatment was required. Since it is an unusual complication, we conducted a review of the literature describing the mechanisms of silicone migration, diagnosis, and management of this silicone granuloma. Our report is the first report from the UK to our knowledge. We identified four more cases reported from the USA, Colombia, and Italy. In conclusion, the diagnosis of silicone granuloma in the liver is challenging since clinical features are occult, and they mimic metastatic deposits on imaging. Its diagnosis and management necessitate input from a multidisciplinary team. Clinicians should maintain a high index of suspicion of silicone migration in patients who present with unexplained hepatic lesions and have had a breast implant inserted in the past.

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