Anaplastic Large-Cell Lymphoma Associated with Breast Implants: A Case Report of a Transgender Female

• Published in: Aesthetic plastic surgery 2018-04, Vol.42 (2), p.451-455
• Main Authors: Patzelt, Matej, Zarubova, Lucie, Klener, Pavel, Barta, Josef, Benkova, Kamila, Brandejsova, Adrianna, Trneny, Marek, Gürlich, Robert, Sukop, Andrej
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols; Biopsy, Needle; Breast Implantation - adverse effects; Breast Implantation - methods; Breast Implants - adverse effects; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - etiology; Breast Neoplasms - therapy; Case Report; Case reports; Combined Modality Therapy; Cyclophosphamide; Device Removal; Doxorubicin; Female; Follow-Up Studies; Humans; Immunohistochemistry; Lymphoma; Lymphoma, Large-Cell, Anaplastic - diagnostic imaging; Lymphoma, Large-Cell, Anaplastic - etiology; Lymphoma, Large-Cell, Anaplastic - therapy; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Otorhinolaryngology; Plastic Surgery; Positron Emission Tomography Computed Tomography; Prednisone; Silicone Gels - adverse effects; Transgender Persons; Transplants & implants; Treatment Outcome; Vincristine
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-017-1012-y

Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare peripheral T cell lymphoma. BIA-ALCL is a disease of the fibrous capsule surrounding the implant and occurs in patients after both breast reconstruction and augmentation. More than 300 cases have been reported so far, including two in a transgender patient. Here we describe BIA-ALCL presented with a mass in a transgender patient and the first case of BIA-ALCL in the Czech Republic. In 2007, a 33-year-old transgender male to female underwent bilateral breast augmentation as a part of his transformation to female. In June 2014, the patient developed a 5-cm tumorous mass in her left breast. Magnetic resonance imaging of the chest revealed a ruptured implant and a tumorous mass penetrating into the capsule and infiltrating the pectoral muscle. An R0 surgery was indicated—the implant, silicone gel and capsule were removed, and the tumorous mass was resected together with a part of the pectoral muscle. Histology revealed anaplastic large-cell lymphoma. The patient underwent standard staging procedures for lymphoma including a bone marrow trephine biopsy, which confirmed stage IE. The patient was treated with the standard chemotherapy for systemic ALCL—6 cycles of CHOP-21. The patient was tumor-free at the 2-year follow-up. BIA-ALCL has been reported mostly in women who received implants for either reconstructive or aesthetic augmentation. This is the third report of BIA-ALCL in a transgender person, the first in the Czech Republic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .