SilikonomL92.8

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

sclerosing lipogranuloma; siliconoma

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DefinitionThis section has been translated automatically.

Traumatogenic lipogranuloma after injection of silicone. S.a.u. Oleoma, paraffinoma.

EtiopathogenesisThis section has been translated automatically.

Foreign body reaction, with formation of a sarcoid granuloma with birefringent crystals (see also tattoo).

ManifestationThis section has been translated automatically.

At times, silicones were used on a large scale (especially in the USA) as fillers and augmentation agents. Even after years, injected silicone can cause granulomatous local reactions.

Clinical featuresThis section has been translated automatically.

Plate-like, mostly painless tumenescences occurring in different levels of the skin, subcutis or musculature, restricted to the site of injection (rarely beyond this site); ulceration of the nodules occurs less frequently. Overlying skin appears normal or hyperpigmented.

HistologyThis section has been translated automatically.

Mostly in the subcutis there are sclerotic connective tissue areas with enclosed optically empty vacuoles, which give the impression of a Swiss cheese. Circumscribed granulomas with giant foreign body cells complete the picture.

DiagnosisThis section has been translated automatically.

Histology and anamnesis are diagnostic.

Differential diagnosisThis section has been translated automatically.

Oleoma (paraffinoma); see also lipogranuloma, traumatogenic.

TherapyThis section has been translated automatically.

Complete excision if possible.

Case report(s)This section has been translated automatically.

  • A 30-year-old female patient presents with pronounced lymphedema of the legs. 5 years ago, an injection of 3 l silicone (!) was given to improve the contour of the buttocks and hips. Approximately 1 year later the beginning of slightly painful indurations, pigment disorders, subcutaneous nodules as well as progressive, painful swelling of the feet and legs.
  • Findings: Brownish hyperpigmentation with plate-like subcutaneous nodules, clearly enlarged, painless, inguinal lymph nodes; pronounced lymphedema of the lower extremities with pos. stemmer sign.
  • Laboratory values without exception normal. Thorax: No pathological findings. MRT: Diffuse subcutaneous accumulation of contour conglomerates on hip, OS and buttocks.
  • Deep excision biopsy: Foreign body granuloma with the characteristic features of the siliconoma (Swiss cheese pattern).

LiteratureThis section has been translated automatically.

  1. Gaber Y (2004) Secondary lymphoedema of the lower leg as an unusual side-effect of a liquid silicone injection in the hips and buttocks. Dermatology 208: 342-344
  2. Salmi R et al (2004) Siliconoma: an unusual entity for the internist. On J Med 116: 67
  3. Sinrachtanant C et al (2003) Sclerosing lipogranuloma of the nose: a new treatment using adipose tissue transplantation. Facial Plast Surgery 19: 363-367

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Last updated on: 29.10.2020