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).