title: [Radiological trap and oncological precautions in a patient who has undergone a permanent withdrawal of PIP breast implants].
abstract: We report the case of a 57-year-old patient who presented radiological images similar to ruptured breast implants one year after the supposed withdrawal of the latter. This woman had benefited for the first time from cosmetic PIP breast implants in 2000. Early in 2014, she requested the removal of the implants without renewal because she was feeling pain and functional discomfort. A few months after the operation, she consulted for breast swelling in the upper pole of the breast. Radiological assessment showed liquid formations compatible with the presence of implants. At our request, the rereading of the MRI by the radiologist definitively concluded on a bilateral seroma within the persistent fibrous capsule. In the absence of symptoms, clinical monitoring had been decided. But at the recrudescence of anaplastic large cell lymphoma cases associated with breast implants, a cytological sampling was intended. In case of cytological abnormality or recurrence of the seroma, a surgical procedure should be performed. In conclusion, the removal of a breast implant without capsulectomy may result in the formation of a seroma whose images resemble those of an implant. It is always worthwhile to provide precise clinical data to the radiologist in order to help him to make informed interpretations. Every serous effusion in a breast lodge having contained a silicone implant must evoke the diagnosis of anaplastic large cell lymphoma.
authors.affiliation: Service de chirurgie plastique et reconstructrice, hôpital civil, CHU de Strasbourg, 1, place de l'Hôpital, B.P. n(o) 426, 67091 Strasbourg cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Koutsomanis
authors.affiliation: Service de chirurgie plastique et reconstructrice, hôpital civil, CHU de Strasbourg, 1, place de l'Hôpital, B.P. n(o) 426, 67091 Strasbourg cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Bruant-Rodier
authors.affiliation: Service de radiologie, unité d'imagerie de la femme, CHU de Strasbourg, 67098 Strasbourg cedex, France.
authors.forename: M-N
authors.initials: MN
authors.lastname: Roedlich
authors.affiliation: Service de radiologie, unité d'imagerie de la femme, CHU de Strasbourg, 67098 Strasbourg cedex, France.
authors.forename: M-F
authors.initials: MF
authors.lastname: Bretz-Grenier
authors.affiliation: Service de chirurgie plastique et reconstructrice, CHU de Nantes, 44093 Nantes cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Perrot
authors.affiliation: Service de chirurgie plastique et reconstructrice, hôpital civil, CHU de Strasbourg, 1, place de l'Hôpital, B.P. n(o) 426, 67091 Strasbourg cedex, France. Electronic address: frederic.bodin@chru-strasbourg.fr.
authors.forename: F
authors.initials: F
authors.lastname: Bodin
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging*; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000175:diagnosis; D020878:Device Removal; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D049291:Seroma / Q000000981:diagnostic imaging*
keywords: Anaplastic large cell lymphoma (ALCL); Breast implant; Implant mammaire; Lymphome anaplasique à grande cellule (LAGC); Poly Implant Prothèse (PIP); Seroma; Sérome