乳房植入物,无论是用于重建还是美容目的,很少是终身设备。断裂,由于植入物外壳完整性受损,和由通常在乳房植入物周围形成的特殊疤痕组织收缩引起的包膜挛缩,早已被认可,并且仍然是植入物失败的主要原因。很明显,然而,乳房植入物的女性也可能由于一系列病因因素而经历延迟性乳房肿胀。虽然大多数与乳房植入物相关的延迟血清瘤具有良性病因,如果没有足够的检查,如乳房植入物相关的间变性大细胞淋巴瘤(BIA-ALCL)等恶性肿瘤,则不能忽略这种表现,乳房植入物相关弥漫性大B细胞淋巴瘤(BIA-DLBCL),和乳房植入物相关鳞状细胞癌(BIA-SCC)可以有类似的临床表现。由于这些恶性肿瘤的发生频率足够高,有时会带来致命的后果,必须承认它们的存在,并实施适当的诊断方法。一个由整形外科医生组成的多学科团队,放射科医生,病理学家,and,根据需要,外科和医学肿瘤学家可以加快明智的护理。在此,我们回顾并进一步表征可能导致乳房植入物周围肿胀延迟的条件。
Breast implants, whether placed for reconstructive or cosmetic purposes, are rarely lifetime devices. Rupture, resulting from compromised implant shell integrity, and capsular contracture caused by constriction of the specialized scar tissue that normally forms around breast implants, have long been recognized, and remain the leading causes of implant failure. It is apparent, however, that women with breast implants may also experience delayed breast swelling due to a range of etiologic factors. While a majority of delayed seromas associated with breast implants have a benign etiology, this presentation cannot be ignored without an adequate workup as malignancies such as breast implant associated anaplastic large cell lymphoma (BIA-ALCL), breast implant associated diffuse large B-cell lymphoma (BIA-DLBCL), and breast implant associated squamous cell carcinoma (BIA-SCC) can have a similar clinical presentation. Since these malignancies occur with sufficient frequency, and with sometimes lethal consequences, their existence must be recognized, and an appropriate diagnostic approach implemented. A multidisciplinary team that involves a plastic surgeon, radiologist, pathologist, and, as required, surgical and medical oncologists can expedite judicious care. Herein we review and further characterize conditions that can lead to delayed swelling around breast implants.