Debilitating silicone granuloma of the penis and scrotum.
The restoration and improvement of body contour have intrigued surgeons for over 100 years, generating much interest in the subcutaneous/intradermal injection of highly viscous fluids. The local complications of liquid silicone injection have been well documented over the past 30 years. Although Dow-Corning has not made medical-grade liquid silicone available for use in humans without an approved research application since 1966, practitioners, both licensed and unlicensed, have administered these injections worldwide for a variety of indications throughout the body. There is little or no information concerning the adulteration of these injectates. To date, there have been four case reports of penile injections--the indications being evenly split between the treatment of impotence/sexual inadequacy and augmentation. The most recent description was published in 1982. We present a case of debilitating silicone granuloma of the penis and scrotum secondary to large-volume injections into the corpora cavernosae and penile soft tissues administered in Belgium 14 years prior to presentation. The development of a silicone foreign body reaction, massive edema, and subsequent impotence lends itself to a clinical diagnosis and aggressive treatment with wide local excision and appropriate soft-tissue coverage. The metabolic fate of silicone in vivo remains inadequately characterized and a fertile area for research as new methods involving nuclear magnetic resonance spectroscopy have been devised to identify silicone and highly coordinated silicone complexes.
Wassermann
R J
RJ
Division of Plastic Surgery, University of South Florida, Tampa, USA.
Greenwald
D P
DP
D000328:Adult; D004487:Edema; D005832:Genital Diseases, Male / Q000209:etiology / Q000473:pathology; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006984:Hypertrophy; D007267:Injections; D008297:Male; D010409:Penile Diseases / Q000209:etiology* / Q000473:pathology; D012611:Scrotum / Q000473:pathology; D012828:Silicones / Q000009:adverse effects*
D012828:Silicones