Disseminated silicone granulomatosis in the face and orbit

Purpose: To report a case of disseminated silicone granulomatosis presenting with ptosis, proptosis and vision loss. Observations: A 56-year-old female presented with ptosis, proptosis, and vision loss and was noted to have palpable, erythematous masses involving the orbit, face, trunk, and body. Sh...

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Bibliographic Details
Main Authors: Tiffany A. Chen, Carmel L. Mercado, Katie L. Topping, Benjamin P. Erickson, Kimberly P. Cockerham, Andrea L. Kossler
Format: Article
Language:English
Published: Elsevier 2018-06-01
Series:American Journal of Ophthalmology Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993617302074
Description
Summary:Purpose: To report a case of disseminated silicone granulomatosis presenting with ptosis, proptosis and vision loss. Observations: A 56-year-old female presented with ptosis, proptosis, and vision loss and was noted to have palpable, erythematous masses involving the orbit, face, trunk, and body. She had a history of bilateral silicone breast implants and cosmetic facial filler injections. Orbital biopsy demonstrated non-caseating granulomas with foreign-body giant cells and vacuoles containing material consistent with silicone. Removal of the patient's breast implants and systemic immunosuppression led to dramatic granuloma regression. Conclusions: Silicone can induce a severe, systemic inflammatory response and should be considered in the differential for facial and periorbital granulomas in patients with a history of silicone breast implants. Management of disseminated silicone granulomatosis is challenging and requires multimodal treatment with silicone removal and systemic immunomodulation. Keywords: Silicone, Disseminated, Silicone granulomatosis, Orbit, Breast implants, Autoimmune/inflammatory syndrome
ISSN:2451-9936