Breast implant-associated anaplastic large cell lymphoma. Case report of an undiagnosed form, management and reconstruction (ALCL)
Breast implant-associated anaplastic large cell lymphoma (ALCL) is an extremely rare disease. Is a new nosologic entity with a multifactorial origin and a wide occurrence delay after breast implantation. This article reports the case of a 60 years old patient with a progressive swelling of the right...
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Veröffentlicht in: | Annales de chirurgie plastique et esthétique 2016-06, Vol.61 (3), p.223-230 |
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description | Breast implant-associated anaplastic large cell lymphoma (ALCL) is an extremely rare disease. Is a new nosologic entity with a multifactorial origin and a wide occurrence delay after breast implantation. This article reports the case of a 60 years old patient with a progressive swelling of the right breast after aesthetic breast implants. Diagnostic was delayed because first surgeon was not familiar with the disease. Patient was then referred to us for management. We performed an implant removal and a complete capsulectomy. Pathologic report confirms the diagnostic. After one year and normal ultrasound evaluation, we reconstructed the breast with lipomodeling and mastopexy. Contralateral implant was also removed at time of reconstruction. Vast majority of breast implant-associated ALCL occurs at a time lapse of 11 to 15 years after implant augmentation, with a mean age of 63 years. Among the worldwide 173 cases reported in March 2015, smooth implants seem not to be at risk but 80% of cases were associated with macrotexturized implants. Clinical presentation and diagnostic tools are more and more published but there is to date no recommendation concerning reconstruction delay after implant removal for this pathology. We advise the realization of a breast ultrasound every three months during the first year and wait for a one-year period before reconstruction. In case of aesthetic surgery, mastopexia can be done to allow for glandular shaping. Lipomodeling is an excellent technique to correct the lack of volume due to implant removal. In case of reconstructive setting, implant can be replaced by flap procedure with lipomodeling if needed or lipomodeling alone if recipient site is favorable and patient has enough fat tissue. Contralateral implant should be removed during reconstruction time. |
doi_str_mv | 10.1016/j.anplas.2016.03.003 |
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Case report of an undiagnosed form, management and reconstruction (ALCL)</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Alhamad, S ; Guerid, S ; El Fakir, E H ; Biron, P ; Tourasse, C ; Delay, E</creator><creatorcontrib>Alhamad, S ; Guerid, S ; El Fakir, E H ; Biron, P ; Tourasse, C ; Delay, E</creatorcontrib><description>Breast implant-associated anaplastic large cell lymphoma (ALCL) is an extremely rare disease. Is a new nosologic entity with a multifactorial origin and a wide occurrence delay after breast implantation. This article reports the case of a 60 years old patient with a progressive swelling of the right breast after aesthetic breast implants. Diagnostic was delayed because first surgeon was not familiar with the disease. Patient was then referred to us for management. We performed an implant removal and a complete capsulectomy. Pathologic report confirms the diagnostic. After one year and normal ultrasound evaluation, we reconstructed the breast with lipomodeling and mastopexy. Contralateral implant was also removed at time of reconstruction. Vast majority of breast implant-associated ALCL occurs at a time lapse of 11 to 15 years after implant augmentation, with a mean age of 63 years. Among the worldwide 173 cases reported in March 2015, smooth implants seem not to be at risk but 80% of cases were associated with macrotexturized implants. Clinical presentation and diagnostic tools are more and more published but there is to date no recommendation concerning reconstruction delay after implant removal for this pathology. We advise the realization of a breast ultrasound every three months during the first year and wait for a one-year period before reconstruction. In case of aesthetic surgery, mastopexia can be done to allow for glandular shaping. Lipomodeling is an excellent technique to correct the lack of volume due to implant removal. In case of reconstructive setting, implant can be replaced by flap procedure with lipomodeling if needed or lipomodeling alone if recipient site is favorable and patient has enough fat tissue. Contralateral implant should be removed during reconstruction time.</description><identifier>EISSN: 1768-319X</identifier><identifier>DOI: 10.1016/j.anplas.2016.03.003</identifier><identifier>PMID: 27107559</identifier><language>fre</language><publisher>France</publisher><subject>Adipose Tissue - transplantation ; Breast Implants - adverse effects ; Breast Neoplasms - diagnosis ; Breast Neoplasms - etiology ; Breast Neoplasms - surgery ; Delayed Diagnosis ; Device Removal ; Diagnostic Errors ; Female ; Humans ; Lymphoma, Large-Cell, Anaplastic - diagnosis ; Lymphoma, Large-Cell, Anaplastic - etiology ; Lymphoma, Large-Cell, Anaplastic - surgery ; Mammaplasty ; Middle Aged ; Rare Diseases</subject><ispartof>Annales de chirurgie plastique et esthétique, 2016-06, Vol.61 (3), p.223-230</ispartof><rights>Copyright © 2016 Elsevier Masson SAS. 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Case report of an undiagnosed form, management and reconstruction (ALCL)</title><title>Annales de chirurgie plastique et esthétique</title><addtitle>Ann Chir Plast Esthet</addtitle><description>Breast implant-associated anaplastic large cell lymphoma (ALCL) is an extremely rare disease. Is a new nosologic entity with a multifactorial origin and a wide occurrence delay after breast implantation. This article reports the case of a 60 years old patient with a progressive swelling of the right breast after aesthetic breast implants. Diagnostic was delayed because first surgeon was not familiar with the disease. Patient was then referred to us for management. We performed an implant removal and a complete capsulectomy. Pathologic report confirms the diagnostic. After one year and normal ultrasound evaluation, we reconstructed the breast with lipomodeling and mastopexy. Contralateral implant was also removed at time of reconstruction. Vast majority of breast implant-associated ALCL occurs at a time lapse of 11 to 15 years after implant augmentation, with a mean age of 63 years. Among the worldwide 173 cases reported in March 2015, smooth implants seem not to be at risk but 80% of cases were associated with macrotexturized implants. Clinical presentation and diagnostic tools are more and more published but there is to date no recommendation concerning reconstruction delay after implant removal for this pathology. We advise the realization of a breast ultrasound every three months during the first year and wait for a one-year period before reconstruction. In case of aesthetic surgery, mastopexia can be done to allow for glandular shaping. Lipomodeling is an excellent technique to correct the lack of volume due to implant removal. In case of reconstructive setting, implant can be replaced by flap procedure with lipomodeling if needed or lipomodeling alone if recipient site is favorable and patient has enough fat tissue. Contralateral implant should be removed during reconstruction time.</description><subject>Adipose Tissue - transplantation</subject><subject>Breast Implants - adverse effects</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - etiology</subject><subject>Breast Neoplasms - surgery</subject><subject>Delayed Diagnosis</subject><subject>Device Removal</subject><subject>Diagnostic Errors</subject><subject>Female</subject><subject>Humans</subject><subject>Lymphoma, Large-Cell, Anaplastic - diagnosis</subject><subject>Lymphoma, Large-Cell, Anaplastic - etiology</subject><subject>Lymphoma, Large-Cell, Anaplastic - surgery</subject><subject>Mammaplasty</subject><subject>Middle Aged</subject><subject>Rare Diseases</subject><issn>1768-319X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kE1LxDAQhoMgfqz-A5EcV7A1Sbeb9KiLX7DgRcHbMk0na5cmqUl62Ku_3Ih6GoZ53gfmJeSCs5IzvrzZleDGAWIp8layqmSsOiAnXC5VUfHm_ZicxrhjjC-YUEfkWEjOZF03J-TrLiDERHub8y4VEKPXPSTsKDj4caZe0wHCFqnGYaDD3o4f3kJJVxCRBhx9SNSbjNPJdT1snY85bXyw19RmyRYtupTvXaa1dzGFSafeOzq_Xa_WV2fk0MAQ8fxvzsjbw_3r6qlYvzw-r27XxSg4T0VVN0aAXHRGtwsEY0xbaWwFdrIxS6WgkdhUTLGOtarWUinRdgtd1wIF6lzIjMx_vWPwnxPGtLF9_PkJHPopbrhslBRVLWVGL__QqbXYbcbQWwj7zX9v1Tf9unIr</recordid><startdate>201606</startdate><enddate>201606</enddate><creator>Alhamad, S</creator><creator>Guerid, S</creator><creator>El Fakir, E H</creator><creator>Biron, P</creator><creator>Tourasse, C</creator><creator>Delay, E</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201606</creationdate><title>Breast implant-associated anaplastic large cell lymphoma. 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Case report of an undiagnosed form, management and reconstruction (ALCL)</atitle><jtitle>Annales de chirurgie plastique et esthétique</jtitle><addtitle>Ann Chir Plast Esthet</addtitle><date>2016-06</date><risdate>2016</risdate><volume>61</volume><issue>3</issue><spage>223</spage><epage>230</epage><pages>223-230</pages><eissn>1768-319X</eissn><abstract>Breast implant-associated anaplastic large cell lymphoma (ALCL) is an extremely rare disease. Is a new nosologic entity with a multifactorial origin and a wide occurrence delay after breast implantation. This article reports the case of a 60 years old patient with a progressive swelling of the right breast after aesthetic breast implants. Diagnostic was delayed because first surgeon was not familiar with the disease. Patient was then referred to us for management. We performed an implant removal and a complete capsulectomy. Pathologic report confirms the diagnostic. After one year and normal ultrasound evaluation, we reconstructed the breast with lipomodeling and mastopexy. Contralateral implant was also removed at time of reconstruction. Vast majority of breast implant-associated ALCL occurs at a time lapse of 11 to 15 years after implant augmentation, with a mean age of 63 years. Among the worldwide 173 cases reported in March 2015, smooth implants seem not to be at risk but 80% of cases were associated with macrotexturized implants. Clinical presentation and diagnostic tools are more and more published but there is to date no recommendation concerning reconstruction delay after implant removal for this pathology. We advise the realization of a breast ultrasound every three months during the first year and wait for a one-year period before reconstruction. In case of aesthetic surgery, mastopexia can be done to allow for glandular shaping. Lipomodeling is an excellent technique to correct the lack of volume due to implant removal. In case of reconstructive setting, implant can be replaced by flap procedure with lipomodeling if needed or lipomodeling alone if recipient site is favorable and patient has enough fat tissue. Contralateral implant should be removed during reconstruction time.</abstract><cop>France</cop><pmid>27107559</pmid><doi>10.1016/j.anplas.2016.03.003</doi><tpages>8</tpages></addata></record> |
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subjects | Adipose Tissue - transplantation Breast Implants - adverse effects Breast Neoplasms - diagnosis Breast Neoplasms - etiology Breast Neoplasms - surgery Delayed Diagnosis Device Removal Diagnostic Errors Female Humans Lymphoma, Large-Cell, Anaplastic - diagnosis Lymphoma, Large-Cell, Anaplastic - etiology Lymphoma, Large-Cell, Anaplastic - surgery Mammaplasty Middle Aged Rare Diseases |
title | Breast implant-associated anaplastic large cell lymphoma. Case report of an undiagnosed form, management and reconstruction (ALCL) |
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