HIV lipodystrophy and free silicon-siliconoma

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Anterior chest mass in a patient with history of HIV for 10 years.

Patient Data

Age: 45
Gender: Male

Large amount of soft tissue density overlying the anterior chest.

Recommend CT scan of the chest with contrast.
 

Anterior chest wall (and to a lesser degree anterior abdominal wall) soft tissue multiple low densities in the pectoralis muscle.

Case Discussion

The anterior chest wall (and to a lesser degree anterior abdominal wall) soft tissue multiple low densities in the pectoralis muscle were initially thought to be from HIV lipodystrophy. Unfortunately, he was not on the first generation anti-HIV medications.

HIV patients are known to refuse to admit to silicone injections as there may be a taboo associated. On retrospective review of pathology, the findings are more consistent with the complication of free silicone injections to the chest wall.

Final pathologic diagnosis:

A) RIGHT BREAST TISSUE (REDUCTION): Fibroadipose tissue with extensive fat necrosis, giant cell reaction and fibrotic and partially calcified microcysts (252 g).

B) LEFT BREAST TISSUE (REDUCTION): Fibroadipose tissue with extensive fat necrosis, giant cell reaction and fibrotic and partially calcified microcysts (127 g).

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Case information

rID: 49855
Case created: 6th Dec 2016
Last edited: 25th Jul 2017
Systems: Breast, Chest
Inclusion in quiz mode: Included

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