Inflammatory State After Intrathoracic Breast Implant Placement for Postpneumonectomy Syndrome

Area of Science:

• Cardiothoracic Surgery
• Medical Devices
• Inflammatory Conditions

Background:

• Postpneumonectomy syndrome is a rare complication following lung removal.
• Pulmonary vein atresia necessitates surgical intervention, often leading to pneumonectomy.
• Tissue expanders are used to manage thoracic space deficits after surgery.

Observation:

• A 16-year-old patient developed postpneumonectomy syndrome after right pneumonectomy for pulmonary vein atresia.
• An 800-cm³ saline-filled silicone tissue expander was placed in the right hemithorax, resolving the syndrome.
• Two years later, the patient presented with fevers, night sweats, and arthralgias.

Findings:

• Extensive medical workup ruled out vasculitis, inflammatory bowel disease, and infectious causes for the patient's symptoms.
• Tissue expander removal led to the complete resolution of the patient's systemic inflammatory symptoms.
• This case suggests a potential inflammatory reaction induced by the long-term presence of a silicone tissue expander.

Implications:

• Long-term implanted medical devices, such as tissue expanders, can potentially elicit delayed inflammatory responses.
• Careful consideration of differential diagnoses is crucial when patients with implanted devices develop unexplained systemic symptoms.
• This case highlights the importance of considering device-related complications in the management of patients with a history of thoracic surgery and reconstruction.