Idiopathic Granulomatous Mastitis after Silicone Prosthesis Implantation - Case Report

Idiopathic granulomatous mastitis (IGM) is a rare disease of unknown etiology. In the case report herein discussed, we present a 45-year-old patient with a 40-month breastfeeding history, who underwent prosthesis implant in both breasts and developed IGM. However, we do not know when the disease developed. We removed the prostheses because they produced seroma continuously for a year, and there was no definitive diagnosis. With symptoms worsening until approximately two years after implant surgery, we established the clinical diagnosis of IGM. We aimed to discuss whether the trauma due to implantation could have triggered the disease. We requested several imaging exams and biopsies, and the clinical diagnosis predominated. The patient developed a fistula that lasted for 11 months. She underwent surgery to remove it and treatment with immunosuppressants. Until the end of this report, her illness remained in remission, although there are still nodules in both breasts. Due to treatment controversies, the patient requires monthly follow-up.

Keywords
diagnosis, differential; fistula; granulomatous mastitis; silicone elastomer; persistent infection