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GLUTEAL IMPLANT ASSOCIATED ANAPLASTIC LARGE CELLS LYMPHOMA

Mendes, José M.D.; JUNIOR; Mendes Maykeh, Vinicius A. M.D; Frascino, Luiz Fernando M.D. PhD; Zacchi, Flavia F. S. M.D

Plastic and Reconstructive Surgery: June 5, 2019 - Volume PRS Online First - Issue - p
doi: 10.1097/PRS.0000000000005910
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Background: The association of anaplastic large cells lymphoma to breast implants (BIA-ALCL) has brought back the discussion on the clinical safety of the use of silicone implants.

Case Report: A 63-year-old female came to our institution in early 2015, reporting a gluteal augmentation with silicone implants in 2006 and a recent increasing volume and distortion of the left buttock. Radiologic imaging showed a large amount of fluid collection around the implant. The left side implant was removed and the capsule was left intact presupposing a future re-implantation. The fluid collected was positive for Stafilococcus aureus. Three years later she presented again with a new seroma on the explanted side and was submitted to total capsulectomy and fluid drainage, and the material submitted to laboratorial examination.

Results: Culture was negative. Pathological preparation and sections of the capsule and lumps showed large cells characterized by the horseshoe-shaped nuclei. The immunohistochemistry was positive for CD30/CD4 and negative for ALK, confirming the presence of Anaplastic Large Cells Lymphoma (ALCL), then associated with gluteal implant (GIA-ALCL), event not described in literature. PET-CT and bone marrow biopsy were performed and both did not show any other sites involved.

Conclusions: The same disease in a new location introduces important discussions about the understanding of this pathology and poses certain risks and safety issues to clinical scenarios to be discussed. Regardless a BIA-ALCL or a GIA-ALCL, now we should be probably facing an Implant Augmentation Associated Disease and a new international alert should be addressed to the scientific community.

Plastic surgeon, Titular member of the Brazilian Society of Plastic Surgery, Clinical Director of Clinica de Cirurgia Plastica de Sorocaba, Av. Antonio Carlos Comitre, 659 –Sorocaba –São Paulo – Brasil. ZIP 18.047.620, Phone 55 15 32244442 / 55 15 997711147, Email.: drmendesjr@terra.com.br

Plastic surgeon, specialist member of the Brazilian Society of Plastic Surgery, Member Assistant of Clinica de Cirurgia Plastica de Sorocaba, Av. Antonio Carlos Comitre, 659 –Sorocaba –São Paulo – Brasil. ZIP 18.047.620, Phone 55 15 32244442 / 55 15 997711147, vina_mendes@yahoo.com.br

Titular Member – Brazilian Society of Plastic Surgery, Chief – Plastic Surgery Departament - Hospital do Coração – Instituto de Moléstias, Cardiovasculares de São José do Rio Preto (HC – IMC) Clinical Director Instituto Frascino de Cirurgia Plástica , Av Pres. Juscelino Kubitscheck de Oliveira 3700 - São José do Rio Preto – SP – Brasil. ZIP – 15093-225 Phones: +5517 99116 9116 / 99147 1839, Email zeroplastia@terra.com.br

Pathologist, Fleury Laboratories Group, Av. Gen. Valdomiro de Lima, 508 , Jabaquara, São Paulo – SP – Brasil. ZIP 04344-070, Phone: 55 11 5014-7625., email.: flavia.zacchi@grupofleury.com.brf

FD - The authors have no disclosures with respect to the contents of this article.

©2019American Society of Plastic Surgeons