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Xanthogranulomatous inflammation and spindle cell proliferation in response to silicone breast implant leakage
  1. Kyra Ji-Young Lee1,2,
  2. Jue Li Seah3,
  3. Sandra O’Toole1,2,4 and
  4. Sanjay Warrier1,2,3
  1. 1Sydney Medical Program, The University of Sydney, Sydney, New South Wales, Australia
  2. 2Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
  4. 4Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  1. Correspondence to Kyra Ji-Young Lee; klee5899{at}


This case study highlights the rare complications of silicone breast implants, as well as the diagnostic limitations of imaging. The patient initially presented with leakage of bilateral breast implants as discovered by a positron emission tomography (PET)-computerized tomography (CT) scan performed as part of a workup for small bowel Langerhans cell sarcoma metastases. The imaging results of the PET-CT scan revealed increased activity bilaterally with an enhancing, irregular, heterogeneously enhancing mass in the right breast. Given the clinical suspicion for breast implant-associated anaplastic large cell lymphoma, further investigation including surgical excision was undertaken. What initially was a concern for a serious complication of long-standing breast implants, fortuitously turned out to be a benign but exuberant xanthogranulomatous inflammatory reactive process. We hope that our report will add to the literature of this rare phenomenon and highlight it as a differential diagnosis of a mass in association with breast implants.

  • Breast cancer
  • Breast surgery
  • Plastic and reconstructive surgery
  • Surgical oncology
  • Pathology

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  • Contributors The initial selection of the patient for a case report write-up and assessment of suitability was done by SW and SO'T. Patient consent was sought out by KJ-YL. The preoperative and intraoperative images were photographed by SW. KJ-YL made substantial contributions to the writing, drafting and rewriting of the report. JLS, SW and SO'T provided feedback to the drafts in addition to providing the final approval of the version to be submitted for publication. KJ-YL edited the final draft according to feedback and BMJ guidelines, prepared it for submission and submitted it to the BMJ author interface.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.