Systemic siliconomas following breast implant rupture

We report a case of a woman in her late 40s with a history of breast implant surgery following breast cancer treatment. She presented with asymmetrical breast enlargement, palpable contralateral axillary lymph nodes and cutaneous nodules on both forearms. In addition, imaging evaluation revealed intracapsular implant rupture, ipsilateral internal mammary enlarged lymph nodes and multiple mediastinal lymphadenopathies. Skin and axillary lymph node biopsy demonstrated a chronic granulomatous reaction with foreign-body giant cells related to silicone. Following surgical removal of the breast implant, cutaneous nodules disappeared, and all lymph nodes decreased in size. Systemic deposition of silicone in the form of foreign-body granulomas, also known as siliconomas, is a rare complication of breast implant rupture, which is thought to result from silicone lymphatic or hematogenous migration. In the setting of breast cancer, excluding recurrence should be a priority. While there is no standardised therapeutic approach, implant removal can be an option.