Seroma masquerading as breast prosthesis

Case contributed by Dr. Chris O'Donnell

Presentation

PH of left breast reconstruction post surgery for carcinoma including a retropectoral silicone prosthesis. Rupture of prosthesis about 6 months ago following motor vehicle accident necessitating removal of the prosthesis. Now left chest wall pain and feeling that prosthesis is still in situ!

Patient Data

Age: 65
Gender: Female

Fluid collection with the fibrous capsule created by the prosthesis prior to its removal.   The capsule itself has not been removed (and is seen as a T2 hypointense ring) so fluid has reaccumulated within it looking like a prosthesis.   We know that this fluid is not silicone as there were only water and fat peaks on resonance frequency analysis.  Note on the coronal view small droplets of free silicone are seen in the left breast above the seroma extending up into the axilla as a result of the previous rupture.

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