1142 Silicone Lymphadenopathy Around the Porta Hepatis Lymph Node in a Patient with Prior Use of Silicone Breast Implants - A Case Report
I Martus, S A A Al-Sahee, C Picton, H Devalia, J LordanAbstract
Objective
To present a rare case of silicone lymphadenopathy affecting peri-portal lymph node.
Case report
A 78-year-old female had a history of right sided breast cancer and mastectomy with flap reconstruction and silicon implant 20 years prior to presentation. She had subsequent exchange of her implant in 15 years post original surgery, and then in 2024 she presented with right breast nodule and skin thickening for which punch biopsy was performed and showed a non-necrotizing granuloma. Investigation followed with breast and axillary ultrasound. Subsequent CT scan revealed lymphadenopathy in the porta hepatis nodes among other regions as well. She was referred to general surgery for EUS guided biopsy of the porta hepatis node. This followed removal of her implant due to rupture. Histology from endoscopic ultrasound and biopsy of peri-portal nodes revealed non-necrotising granulomas and no evidence of malignancy likely secondary to silicone.
Discussion
To our knowledge this is the first case report that describes silicone lymphadenopathy presenting in the porta hepatis lymph node. Silicon lymphadenopathy in the axilla is a common complication of breast implants. Other areas of silicone lymphadenopathy reported include supraclavicular, cervical and mediastinal lymph nodes. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a possible mechanism for the granulomatous reactions, however, have not been reported to present in the porta hepatis lymph node.
Conclusions
To our knowledge, this is the first presentation of silicone lymphadenopathy in the peri-portal lymph nodes following any silicone-based breast augmentation rupture and removal.