PMC9871623_01
Physical examination and imaging studies of the patient. A large-sized multinodular mass was on the left chest of a 52-year-old man with a breast implant for past 19 years (A). MRI (B) and CT (C) findings showed a 20-cm sized polycystic mass (red arrow) in front of the implant (green triangle) and multiple irregular masses (blue arrow) in front of the ribs posterior to the implant.
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F1
The skin aspect was normal, without inflammation, ulceration, pigmentation, etc. (Figure 1A). Furthermore, CT demonstrated a similar result (Figures 1B,C). The tumor was negative for estrogen receptor, progesterone receptor, HER2/neu, and calponin, and positive for Ki67, P16, P40, and P63 (Supplementary Figure S1).
Intraoperative appearance of the implant and the mass. The implant (red star) was intact (A); Formation of capsule (green triangle) and presence of several heterogeneous nodules composed of liquid-fillen spaces in which solid papillae project (blue arrow) were observed (B); A polycystic tumor was in front of the implant composed of solid tumor zones (black arrow) and cystic tumor zones (white arrow) (C).
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F2
It was observed that papillary projections invaded into the thoracic cavity and left axilla (Figure 2).
Histology studies of the papillary projections and the mass. The papillary projections and the mass were demonstrated as moderately and poorly differentiated SCC (yellow triangle) arising from the implant capsule. Squamous cells aggregated to form cancer nests (green arrow); H&E x100 (A), H&E x200 (B), and H&E x400 (C).
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F3
SCC arising from the implant capsule and measuring 2.5-3.5 cm (Figure 3). Squamous metaplasia of duct epithelia was observed in the capsule, as well as acute and chronic inflammation, and fibrous tissue hyperplasia (Figure 4).
Histology studies of the duct epithelium. The male mammary duct epithelium (green triangle) was local squamous metaplasia, forming cysts (yellow arrow); H&E x100 (A) and H&E x200 (B).
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F4
SCC arising from the implant capsule and measuring 2.5-3.5 cm (Figure 3). Squamous metaplasia of duct epithelia was observed in the capsule, as well as acute and chronic inflammation, and fibrous tissue hyperplasia (Figure 4).