IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Blunt trauma to a reconstructed breast

Case contributed by Giorgio M. Baratelli
Diagnosis almost certain

Presentation

Fell forward and hit her chest. Underwent breast reconstruction 9 years earlier after skin-sparing mastectomy for DCIS.

Patient Data

Age: 85 years
Gender: Female

Left Breast

ultrasound

Ultrasound study of a periprosthetic fluid collection (seroma) without the rupture of the saline implant

Annotated image

a - the skin and the fibrous capsule

b - the periprosthetic fluid collection

c - the silicone shell of the implants

d - the saline fluid of the implant

Case Discussion

The patient had undergone breast reconstruction with expander and saline implant after skin-sparing mastectomy for multicentric DCIS 9 years earlier.

After 9 years, a blunt chest trauma produced a periprosthetic fluid collection (seroma) detected by ultrasound but did not result in a rupture of the saline implant, which would have caused a change in the size and shape of the affected breast.

An ultrasound-guided fluid aspiration and cytological evaluation, required to rule out breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), an extremely rare form of lymphoma, were indicated but refused by the patient.

The history of chest trauma, the extreme rarity of BIA-ALCL and the collection of fluid without solid nodules to suggest BIA-ALCL, were considered sufficient for the diagnosis. This was confirmed by the stability of the seroma after 4 years.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.