Silicone Fluid-Induced Pulmonary Emboli: A Case Report

Silicone fluid is a good substitute for human subcutaneous fat, but has been associated with many complications, including local tissue granulomatous reaction, systemic sclerosis, connective tissue disease-like syndromes, granulomatous hepatitis, and systemic involvement. It is a well-known illegal procedure for mammary augmentation in Taiwan. Pulmonary involvement in human beings has been reported in a few cases, and presents as acute pneumonitis, pulmonary emboli, and acute respiratory distress syndrome after the silicone injection. We report a 30-year-old previously healthy female who received a silicone fluid injection for mammary augmentation and developed an acute onset of cough, hemoptysis, and progressive dyspnea. Pulmonary embolism was diagnosed from the histopathology of lung tissue obtained from a wedge biopsy, which revealed variably-sized vacuoles within the pulmonary vessels, alveolar septal capillaries and intra-alveolar spaces, extensive intra-alveolar hemorrhage, and a few foamy histocytes infiltrating into the alveolar spaces. After steroid treatment, the patient gradually improved. One month after the silicone fluid injection, the pulmonary function test showed a moderate reduction in the diffusing capacity. The patient had reached a nearly complete recovery without any lung sequence as determined by a follow-up chest roentgenogram and the normal pulmonary function test after eight months.