Silicone Granuloma in the Buttocks Incidentally Detected by 18F-FDG PET/CT 30 Years After Free Liquid Silicone Injections

Abstract

A 59-year-old transexual (male to female) patient presented with a squamous cell carcinoma of the larynx. She underwent an F-FDG PET/CT for initial staging. The examination showed high F-FDG uptake of the primary lesion and a homolateral lymphadenopathy. Incidental heterogeneous uptake of round hyperdense lesions in the gluteal muscles and subcutaneous fat was visualized. The medical history revealed secondly that the patient had had free liquid silicone injections 30 years before the examination. Although the injection of free silicone is not practised since the 1980s, this incidental finding should prompt to check the patient's medical history over several decades.

The Use of Non-Surgical Injectable Procedures Among Transgender Communities

“…Conversely, non-FDA approved non-surgical injectable procedures often result in undesirable and health-threatening outcomes such as local irritation, systemic health complications, and death. [19][20][21][22][23][24][25][26][27] Complications that present great medical concern include post-injection skin bumps, allergic reactions, and pathologic conditions that threaten the circulatory and respiratory systems. Moreover, because these procedures are done by individuals who lack the technical craft of licensed professionals, the results of non-FDA approved non-surgical injectables often compromise self-image -a typically elevated concern among trans individuals.…”

Medical dermatologic conditions in transgender women

“…Reports have shown cases of cellulitis or other skin infections due to these injections. Multiple reports exist on chronic skin ulcers or granulomas in the skin of transgender patients at the site of silicone or hormone injections (Carella et al, 2013, Ohnona et al, 2016, Rothman et al, 2016). Other cutaneous complications include lymphatic and vascular compromise and angioedema/pseudo-angioedema, possibly due to the massive volume of the injections or an inflammatory reaction in the area (Deutsch, 2016, Hage et al, 2001, Styperek et al, 2013).…”