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Case Report
An advanced case of breast implant-associated anaplastic large cell lymphoma
1 Department of Breast Surgery, Cork University Hospital, Cork, Ireland
2 Department of Radiology, Cork University Hospital, Cork, Ireland
3 Department of Pathology, Cork University Hospital, Cork, Ireland
4 Department of Plastic Surgery, Cork University Hospital, Cork, Ireland
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C Cullinane
Department of Breast Surgery, Cork University Hospital, Cork,
Ireland
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Article ID: 101148Z01CC2020
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Cullinane C, Leary PO, O’Sullivan MJ, Corrigan MA, Marshall N, Browne TJ, Kelly J, Redmond HP, Kelly L. An advanced case of breast implant-associated anaplastic large cell lymphoma. Int J Case Rep Images 2020;11:101148Z01CC2020.ABSTRACT
Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin lymphoma that was first described in the literature in 1997. The most common clinical presentation of BIA-ALCL is a persistent seroma, which can be accompanied by breast swelling, asymmetry, or pain. Approximately 30% of patients present with a tumor mass.
Case Report: A 66-year-old woman underwent bilateral mastectomies and immediate implant reconstruction for screen detected ductal carcinoma in situ (DCIS) of the right breast in January 2016. Four years later the patient presented with a right breast mass that developed over a period of weeks. Radiological and pathological investigations confirmed the presence of multifocal mass forming BIA-ALCL with axillary, sub-pectoral, and intra-mammary lymph node involvement. Following multi-disciplinary team (MDT) input, definite was surgery and was also performed. En bloc resection of the right breast tumors and capsulectomy was performed in parallel with left breast explantation and capsulectomy. An axillary lymph node clearance of the right axilla was performed. The patient had an uneventful postoperative recovery and was discharged on post-operative day 5. Following MDT discussion the patient is awaiting adjuvant chemo/radiation therapy.
Conclusion: All patients presenting with a delayed spontaneous seroma (>1 year after implantation) after placement of a textured implant should be investigated for BIA-ALCL. In the majority of cases explantation and total capsulectomy is curative and patients will have an excellent survival outcome.
Keywords: Anaplastic, Breast implant, Lymphoma
SUPPORTING INFORMATION
Acknowledgments
We would like to acknowledge Dr. Peter G Cordeiero from Memorial Sloan Kettering for his expert opinion contribution to the management of this case.
Author ContributionsC Cullinane - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
P O Leary - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Final approval of the version to be published
M J O’Sullivan - Interpretation of data, Drafting the article, Final approval of the version to be published
M A Corrigan - Interpretation of data, Drafting the article, Final approval of the version to be published
N Marshall - Interpretation of data, Drafting the article, Final approval of the version to be published
T J Browne - Interpretation of data, Drafting the article, Final approval of the version to be published
J Kelly - Drafting the article, Final approval of the version to be published
H P Redmond - Drafting the article, Final approval of the version to be published
L Kelly - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 C Cullinane et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
