Ultrasound diagnosis of polyacrylamide mammary syndrome after augmentation mammaplasty with gel injection (clinical case report)

The article presents a clinical case report of complications associated with polyacrylamide gel (PAAG) injection, identified during breast ultrasound. The ultrasound findings are consistent with polyacrylamide mammary syndrome. Patient N., 58, with a history of PAAG injection in 1995, presented with complaints of breast pain and fullness, asymmetry, compaction, and enlargement of the left breast. A breast ultrasound revealed multiple nodular lesions, which should be differentiated between “gelomas” (silicone or polyacrylamide gel induced granulomas) and breast tumors. This clinical case presents ultrasound features for the differential diagnosis of gel collections and tumors. Particular attention is paid to the potential of multiparametric ultrasound for the differential diagnosis of gelomas and malignant breast masses using modern ultrasound techniques. The patient underwent multiparametric ultrasound in B-mode, color Doppler imaging, and contrast-enhanced ultrasound (CEUS). The use of power and color Doppler imaging (CDI) helps assess the anatomy of breast vessels and blood flow velocity, identifying areas of increased blood flow. It is emphasized that ultrasound in the presence of polyacrylamide gel (PAAG) in the mammary glands is significantly complicated. Due to the similarity in the ultrasound appearance of gelomas and malignant masses, it is important for operator to be familiar with the ultrasound features of complications associated with the  PAAG injections. The article presents data on the subsequent treatment and follow-up of this patient.

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