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Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
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Axillary lymphadenopathy due to Swanson implants

S A Bernstein1, R W Strickland, E Lazarus

  • 1Department of Medicine, Walter Reed Army Medical Center, Washington, DC.

The Journal of Rheumatology
|June 1, 1993
PubMed
Summary

Unilateral axillary lymphadenopathy in an elderly woman was linked to silastic elastomer implants used for rheumatoid arthritis. Pathologic evaluation confirmed foreign body reaction, not malignancy, in this rare case.

Area of Science:

  • Rheumatology
  • Pathology
  • Biomaterials Science

Background:

  • Rheumatoid arthritis (RA) management often involves surgical interventions, including the use of silicone-based implants.
  • Swanson silastic elastomer implants are utilized for hand reconstruction in patients with severe RA.
  • Long-term implant presence can potentially lead to unforeseen complications.

Observation:

  • An elderly female patient with a history of RA presented with unilateral axillary lymphadenopathy.
  • The patient had undergone placement of Swanson silastic elastomer implants in her right hand 7 years prior.
  • No apparent cause for the lymphadenopathy was initially identified, raising concerns for malignancy.

Findings:

  • Histopathological examination of the axillary lymph node revealed the presence of foreign body giant cells.

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  • These cells showed a reaction to silastic material, consistent with a foreign body response.
  • Crucially, no evidence of malignancy was detected in the lymph node.

    • Implications:

    • This case highlights a rare complication of silastic elastomer implants, presenting as lymphadenopathy mimicking malignancy.
    • It underscores the importance of considering implant-related foreign body reactions in the differential diagnosis of lymphadenopathy, even years after implantation.
    • Further awareness and investigation may be warranted given the widespread use of such implants in RA patients.