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Weekly Chest CasesArchive of Old Cases

Case No : 663 Date 2010-07-11

  • Courtesy of Kun Young Lim, Hyae Young Kim, Soo Hyun Lee. / National Cancer Center, Korea.
  • Age/Sex 54 / F
  • Chief ComplaintRoutine post op. follow up (s/p Robot assisted thoracoscopic left lower lobectomy d/t lung cancer), PHx: Breast implants
  • Figure 1
  • Figure 2
  • Figure 3

Preoperative chest x-ray

Diagnosis With Brief Discussion

Diagnosis
Intrathoracic migration of the left breast implant
Radiologic Findings
Fig. 1
Preoperative chest radiograph shows increased opacities in bilateral lower thoraces suggesting breast implants, and a nodule in left lower lung field.
Fig.2
Chest radiograph obtained after robot assisted thoracoscopic left lower lobectomy shows triangular shaped opacity in left paravetebral area. The opacity of the breast implant in left lower thorax is not seen.
Fig. 3
Contrast enhanced CT scan shows a low attenuation mass with high density curvilinear opacity at left posterior pleural cavity.
Fig. 4, 5. Pre-operative (Fig. 4) and post-operative (Fig.5) CT scans. Postoperative CT scan demonstrates a breast implant in situ in the right breast and an empty subpectoral cavity in the left breast, with intrathoracic migration of the left breast implant.

Fig 4.

Fig 5.

Brief Review
Intrathoracic migration of breast implant is very rare complication of breast augmentation and can lead to significant patient discomfort and respiratory complications.
In this case, it is conceivable that the negative intrathoracic pressure led to forced migration of the pliable breast implant through a small pleural defect of post-operation chest tube insertion site.
References
1. Mehta AM, Bard MP, Straten A, et al. Intrathoracic migration of a breast prosthesis after thoracotomy. J Thorac Cardiovasc Surg 2008; 135: 206-7
Keywords
Pleura, Chest wall, Trauma, Postoperative complication,

No. of Applicants : 96

▶ Correct Answer : 43/96,  44.8%
  • - Hangang sacred heart hospital , Korea (South) You Mie Han
  • - , Korea (South) Hun-cheol lim
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - Bundang CHA hospital , Korea (South) Jung Jin Young
  • - Radiologie Brabois adultes , France ROPION helene
  • - Bundang CHA hospital , Korea (South) Sojung Kim
  • - InRad - HCFMUSP S�o Paulo , Brazil Natanael Ahn
  • - SMC , Korea (South) JI MIN
  • - Virgin Mary Hospital Burgas , Bulgaria VLADISLAV RUSINOV
  • - SEOUL NATIONAL UNIVERSITY HOSPITAL , Korea (South) SANG LEE
  • - Radnet Teleradiology , Turkey Murat Ulusoy
  • - CNUH , Korea (South) Hyedoo Jung
  • - Department of Radiology, Chonnam National University Hospital , Korea (South) Hyungjun Kim
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
  • - Chonnam National University Hwasoon Hospiral , Korea (South) You Ri Choi
  • - chonnam national university hospital , Korea (South) Seoyeon Park
  • - CNUH , Korea (South) Seoin Jeong
  • - Chonnam national university hospital , Korea (South) SeungJin Lee
  • - Chonnam national university hospital , Korea (South) Jang-hyeon Song
  • - Chonnam university hospital , Korea (South) LEE HYUN
  • - Chonnam National University Hospital , Korea (South) Jun Hyung Hong
  • - Chonnam national university hospital , Korea (South) Hyeong wook Kim
  • - Chonnam university hospital , Korea (South) Minyoung Jung
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Hopital de Pau , France Mathieu Cannella
  • - Shinchon Severance Hospital , Korea (South) Ho-Joon Lee
  • - KUMC ansan , Korea (South) kihwan kim
  • - McGill University , Canada Ben Smith
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Hanyang university Guri hospital , Korea (South) Eung tae Kim
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - All India Institute of medical sciences , India Justin Moses
  • - Apollo Gleneagles hosp kolkata , India SALIM PARVEZ
  • - IMS, BHU,VARANASI , India sriram patwari
  • - Chonnam National University Hospital , Korea (South) Jung Hyun Kim
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - Uzunkopru Devlet Hastanesi , Turkey Armagan Sarac
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - Song-do Hospital , Korea (South) Ji-young Yun
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - PITTWATER RADIOLOGY , Australia Julie Arora
▶ Correct Answer as Differential Diagnosis : 1/96,  1.0%
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
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