Anatomic Pathology of Mammary Siliconomas

  • Baltasar Eduardo Lema
  • Alejandra Maciel


Siliconomas are pseudotumors formed by infiltration of tissues by silicone and the consequent granulomatous reaction. They may be due to direct infiltration of silicones or from rupture of a breast prosthesis; in both instances, the histological characteristics of the granulomatous reaction are similar.

Histologically, silicones are observed, partly, as deposits of an extracellular exogenous material that does not stain in Hematoxylin Eosin-histologic sections. They have a variable diameter, with well-defined and refringent edges, sometimes with an acidophilic hyaline membrane. This is surrounded by an histiocytic granulomatous reaction, the histiocytes have microvacuoles in their cytoplasm, which is the other way in which silicones are observed in tissues. Microvacuoles are also refringent, which differentiates them from the lipophagic histiocytes observed in adipose tissue necrosis. The granulomatous reaction of siliconomas frequently includes multinucleated giant cells, also with silicone microvacuoles; in some cases, asteroid bodies, similar to those seen in sarcoidosis, are observed within the vacuoles.

We now present a case of a siliconoma, formed after the direct injection of liquid silicone, within which a carcinoma developed. We believe that these images, of a carcinoma infiltrating a siliconoma, are unique, since we have been unable to find any others similar to this in the medical literature.


Filtration of silicone Histology Anatomic pathology Immune response Infiltrating carcinoma Reaction of autoimmunity 


  1. 1.
    Raso DS, Greene WB, Metcalf JS. Synovial metaplasia of a periprosthetic breast capsule. Arch Pathol Lab Med. 1994;118:249–51.PubMedGoogle Scholar
  2. 2.
    Raso DS, Crymes LW, Metcalf JS. Histological assessment of fifty breast capsules from smooth and textured augmentation and reconstruction mammoplasty prostheses with emphasis on the role of synovial metaplasia. Mod Pathol. 1994;7:310–6.PubMedGoogle Scholar
  3. 3.
    Emery JA, Spanier SS, Kasnic G Jr, Hardt NS. The synovial structure of breast-implant-associated bursae. Mod Pathol. 1994;7:728–33.PubMedGoogle Scholar
  4. 4.
    Del Rosario AD, Bui HX, Petrocine S, et al. True synovial metaplasia of breast implant capsules: a light and electron microscopic study. Ultrastruct Pathol. 1995;19:83–93.CrossRefGoogle Scholar
  5. 5.
    Kasper CS. Histologic features of breast capsules reflect surface configuration and composition of silicone bag implants. Am J Clin Pathol. 1994;102:655–9.CrossRefGoogle Scholar
  6. 6.
    Hameed MR, Erlandson R, Rosen PP. Capsular synovial-like hyperplasia (CSH) around mammary implants similar to dendritic synovitis: a morphologic and immunohistochemical study of 15 cases. Am J Surg Pathol. 1995;19:433–8.CrossRefGoogle Scholar
  7. 7.
    Katzin WE, Feng LJ. Phenotype of lymphocytes associated with the inflammatory reaction to silicone-gel breast implants. Lab Investig. 1994;70:17.Google Scholar
  8. 8.
    Raso DS. B and T lymphocytes in periprosthetic breast capsules. Lab Investig. 1994;70:20.Google Scholar
  9. 9.
    Kossovsky N, Freiman CJ. Silicone breast implant pathology: clinical data and immunologic consequences. Arch Pathol Lab Med. 1994;118:686–93.PubMedGoogle Scholar
  10. 10.
    Wells AF, Daniels S, Gunasekaran S, Wells KE. Local increase in hyaluronic acid and interleukin-2 in the capsules surrounding silicone breast implants. Ann Plast Surg. 1994;33:1–5.CrossRefGoogle Scholar
  11. 11.
    Sahoo S, Rosen PP, Federsen RM, et al. Anaplastic large cell lymphoma arising in a silicone breast implant capsule: a case report and review of the literature. Arch Pathol Lab Med. 2003;127:115–8.Google Scholar
  12. 12.
    Roden AC, Macon WR, Keeney GL, et al. Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder. Mod Pathol. 2008;21:455–63.CrossRefGoogle Scholar
  13. 13.
    Peters W, Smith D. Calcification of breast implant capsules: incidence, diagnosis, and contributing factors. Ann Plast Surg. 1995;34:8–11.CrossRefGoogle Scholar
  14. 14.
    Van Diest PJ, Beekman WH, Hage JJ. Pathology of silicone leakage from breast implants. J Clin Pathol. 1998;51:493–7.CrossRefGoogle Scholar
  15. 15.
    Shipchandler TZ, Lorenz RR, McMahon J, Tubbs R. Supraclavicular lymphadenopathy due to silicone breast implants. Arch Otolaryngol Head Neck Surg. 2007;133:830–2.CrossRefGoogle Scholar
  16. 16.
    Bauer PR, Krajicek BJ, Daniels CE, et al. Silicone breast implant-induced lymphadenopathy:18 cases. Respiratory Medicine CME. 2011;4:126–30.CrossRefGoogle Scholar
  17. 17.
    Truong LD, Cartwright J Jr, Goodman MD, Woznicki D. Silicone lymphadenopathy associated with augmentation mammaplasty. Morphologic features of nine cases. Am J Surg Pathol. 1988;12:484–91.CrossRefGoogle Scholar
  18. 18.
    Rivero MA, Schwartz DS, Mies C. Silicone lymphadenopathy involving intramammary lymph nodes: a new complication of silicone mammaplasty. Am J Roentgenol. 1994;161:1089–90.CrossRefGoogle Scholar
  19. 19.
    Vaamonde R, Cabrera JM, Vaamonde-Martin RJ, et al. Silicone granulomatous lymphadenopathy and siliconomas of the breast. Histol Histopatol. 1997;12:1003–11.Google Scholar
  20. 20.
    Katzin WE, Centeno JA, Feng LJ, et al. Pathology of lymph nodes from patients with breast implants. A histologic and spectroscopy evaluation. Am J Surg Pathol. 2005;29:506–11.CrossRefGoogle Scholar
  21. 21.
    Schenone GE. Siliconomas Mamarios por Inyección: Clínica, Diagnóstico y Tratamiento. Buenos Aires: Journal; 2017. p. 117–23.Google Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Baltasar Eduardo Lema
    • 1
  • Alejandra Maciel
    • 2
  1. 1.Former President International Academy of Pathology, UBABuenos AiresArgentina
  2. 2.Rivadavia Hospital, Universidad del Salvador, UBABuenos AiresArgentina

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