We present a case of an 81-year-old woman who presented to the emergency department with bleeding from a right breast wound. The patient had prior imaging suggestive of bilateral silicone implant rupture and a history of low tolerance for MRI scans. Ultrasound imaging in the emergency setting showed findings in the right breast suggestive of a fistula with free silicone and hematoma. A subsequent photon-counting CT scan with custom silicone-specific segmentation allowed differentiation of silicone from hematoma, provided anatomic assessment and location of the fistula, and revealed bilateral silicone-induced lymphadenopathy.
Keywords: Emergency department; Extracapsular rupture; Extracorporeal extrusion; Lymphadenopathy; Photon-counting CT; Silicone breast implants.
© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.