Extra capsular breast implant rupture

Case contributed by Simon Rupret

Presentation

Routine outpatient scan for prolonged productive cough following an unremarkable chest XR.

Patient Data

Age: 55 years
Gender: Female

Non-contrast CT thorax

ct

Incidental finding of an irregular left breast implant, reduced in volume compared to the right. There is extra capsular silicone (55HU) in the soft tissues of the breast, extending beyond the margins of the implant. Linguine sign can be seen medially. 

There are several small lymph nodes in the left axilla containing calcification, suggesting chronic irritation by silicon bleeding.

No significant lung or bone findings.

Case Discussion

Incidental finding on a routine CT thorax.

Implant ruptures can be subdivided into intra and extra capsular. CT is not a modality of choice for diagnosing a rupture and breast MRI is preferred. 

In the case of a ruptured saline implant, only the capsule remains after the saline is absorbed by the body. In case of a silicone implant rupture, this remains in the soft tissue, the small amounts that do get taken up in lymphatics tend to drain to the axillary lymph nodes causing enlargement or calcification.

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