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      A Rare Case of BIA-ALCL Mass Associated with Mastectomy Skin Flap Erythema After Immunization with COVID-19

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          Abstract

          Background

          The immune response to breast implants after COVID-19 disease or COVID-19 vaccine administration includes acute inflammatory manifestations, capsular contracture and seroma. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare tumor in which numerous up-regulated pro-inflammatory immunological pathways activate a T cell lymphoproliferative disorder.

          Methods

          The first reported case of a BIA-ALCL hidden mass clinically manifesting with inflammatory signs after SARS-CoV-2 infection and vaccinations is here described.

          Results

          Complete capsulectomy and adjuvant chemotherapy were performed and immediately after the surgical procedure local inflammatory signs disappeared; no evidence of disease was present 1 year later.

          Conclusions

          Immunological stimulation by COVID-19 disease and vaccines may highlight some rare clinical manifestations of BIA-ALCL; persistent inflammatory symptomatology over breast implants should be investigated using second-level imaging.

          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.

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          Most cited references12

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          Distinct antibody and memory B cell responses in SARS-CoV-2 naïve and recovered individuals following mRNA vaccination

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            Potential immune response to breast implants after immunization with COVID-19 vaccines

            Besides reports of alarming potential side effects after COVID-19 vaccinations there have been rare observations of rather benign reactions to foreign materials such as cosmetic hyaluronic acid filler injections after a COVID-19 immunization. Likewise to dermal fillers any foreign material may cause a reaction when the immune system is triggered. In the recent weeks we observed four noteworthy potential reactions in association with breast implants between one and three days after COVID-19 vaccinations. We release these information at the earliest to educate colleagues and draw attention to possible reactions between the COVID-19 vaccines and foreign bodies such as breast implants.
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              Breast implant seroma: A SARS‐CoV‐2 mRNA vaccine side effect

              Fluid collection surrounding breast implants, called seroma, is a frequent issue that has diverse etiologies. We describe a 48‐year‐old woman with an acute onset of bilateral breast swelling occurring 5 years after aesthetic surgery and 10 days after a second SARS‐CoV‐2 mRNA vaccine dose. At breast ultrasound, we found an abundant bilateral peri‐implant seroma. Our patient noticed symptom improvement 48 h after nonsteroidal anti‐inflammatory drug treatment, complete disappearance of symptoms after 10 days with seroma disappearance documented by ultrasound. We hypothesized a breast implant seroma as post‐SARS‐CoV‐2 mRNA vaccine side effect, as different other diagnosis had been excluded.
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                Author and article information

                Contributors
                eleonoradeantoni@gmail.com , eleonora.deantoni@aovr.veneto.it
                Journal
                Aesthetic Plast Surg
                Aesthetic Plast Surg
                Aesthetic Plastic Surgery
                Springer US (New York )
                0364-216X
                1432-5241
                15 November 2022
                : 1-6
                Affiliations
                [1 ]GRID grid.15667.33, ISNI 0000 0004 1757 0843, Department of Plastic and Reconstructive Surgery, , IEO European Institute of Oncology, ; Milan, Italy
                [2 ]GRID grid.411475.2, ISNI 0000 0004 1756 948X, Department of Plastic and Reconstructive Surgery, , AOVR Verona University Hospital, ; Piazzale Stefani 1, 37126 Verona, Italy
                [3 ]GRID grid.15667.33, ISNI 0000 0004 1757 0843, Haematopathology Division, IEO European Institute of Oncology, ; Milan, Italy
                [4 ]GRID grid.15667.33, ISNI 0000 0004 1757 0843, Clinical Haemato-Oncology, , IEO European Institute of Oncology, ; Milan, Italy
                [5 ]GRID grid.15667.33, ISNI 0000 0004 1757 0843, Haematopathology Division, IEO European Institute of Oncology, ; Milan, Italy
                Author information
                http://orcid.org/0000-0003-3546-4377
                Article
                3174
                10.1007/s00266-022-03174-1
                9666973
                36380099
                be247111-97a5-4e23-9f0e-60ee8e712167
                © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 27 August 2022
                : 5 November 2022
                Categories
                Case Report

                Surgery
                bia-alcl,covid-19,inflammatory signs,erythema,tenderness
                Surgery
                bia-alcl, covid-19, inflammatory signs, erythema, tenderness

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