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When a late-onset peri-prosthetic seroma is not anaplastic large cell lymphoma: a case report of a breast implant-associated plasmacytoma and literature review of non-ALCL breast implant-associated ne
Fernando Ovalle Jr, MD
Sam Ahmed Beyoun, BS
Chris van Belle, MD
Ryan Gobble, MD
University of Cincinnati Medical Center
2018-02-05
Presenter: Fernando Ovalle Jr, MD
Affidavit:
Yes
Director Name: John Kitzmiller, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose/Methods:
With approximately 400 cases reported to date, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare T cell lymphoma that typically presents with a late-onset peri-prosthetic seroma. More rare are other lymphomas associated with breast implants. Here we describe the case of a patient with a primary breast implant-associated plasmacytoma as well as review the literature of all non-ALCL breast implant-associated lymphomas.
Results:
A 56-year-old female presented to an outside hospital in November 2016 with a new-onset unilateral seroma 20 years post-implantation of smooth round silicone breast implants for cosmetic augmentation. The seroma was aspirated, and samples demonstrated inflammation without infection. She was referred to us for further workup. ALCL was suspected, but fine needle aspirate was negative for CD30 and other malignancy markers. Bilateral capsulectomy and implant removal was performed in June 2017. Histopathology and oncology workup diagnosed a solitary extramedullary plasmacytoma (CD138, CD56 positive) within the left breast implant capsule.
A literature review of all non-ALCL lymphomas reported to be associated with breast implants was performed, revealing eight cases reported to date. Patient and tumor characteristics are summarized separately in Table 1.
Conclusion:
This is the first case report of a breast implant-associated solitary extramedullary plasmacytoma, another neoplasm that surgeons should consider when presented with late-onset peri-prosthetic seromas. Although BIA-ALCL is the most common lymphoma associated with breast implants and the work-up remains the same for non-ALCL BIA tumors, this case and review illustrates that there is more to understand regarding other neoplasms associated with breast implants.
Table 1. See attached file.
