False-Positive Axillary Lymph Nodes Due to Silicone Adenitis on 18 F-FDG PET/CT in an Oncological Setting

Abstract

The case of a 49-year-old transgender individual with a history of bilateral silicone breast implants and a right lung mass proven by biopsy to be a non-small cell lung cancer is presented. In addition to the primary malignancy, a positron emission tomography/computed tomography scan showed contralateral hypermetabolic adenopathy in the left axilla that was suggestive of nodal metastatic disease. Additional imaging and histological examination of the lymph nodes indicated silicone breast implant leakage and silicone adenitis as the underlying cause of the hypermetabolic axillary lymph node.

Cancer screening and management in the transgender population: Review of literature and special considerations for gender affirmation surgery

“…This study concluded that careful evaluation and planning can minimize the risk of complications in secondary breast reconstruction post silicone injections. Another study reported a case of TGGD patient with a false-positive axillary lymph nodes due to silicone adenitis from silicone leakage[ 52 ]. A final case reports two incidences TGGD patients with breast inflammation and necrosis as a result of silicone and paraffin injections[ 53 ].…”

Silicone granuloma mimicking Breast Implant Associated Large Cell Lymphoma (BIA-ALCL): a case report

“…Pathologically, granuloma formation is mediated by histocytes and occurs as an inflammatory response to silicone leakage beyond the external capsule [13]. In patients with BIA-ALCL, seroma and mass represent the two most common phenotypes, cited to occur in approximately 80% and 10-20% of patients, respectively [14]. While the presence of implant rupture typically raises suspicion for a benign rather than malignant process, it is worth noting that according to the PROFILE registry, 13.5% of patient with BIA-ALCL had concurrent implant rupture, which likely occurred as a complication of the cancer [3].…”

Silicone implant incompatibility syndrome: Mimicking metastases on fluoro-deoxy-glucose positron emission tomography–computed tomography in a treated case of carcinoma breast

“…Few cases reported in the literature with false-positive finding on FDG PET-CT due to SIIS are summarized in Table 1 . [ 8 9 10 11 12 13 ]…”