Silicone-Induced Granulomatous Reaction Causing Severe Hypercalcemia: Case Report and Literature Review
Table 1
Literature reported hypercalcemia cases following use of cosmetic silicone.
Authors(year)
Age (years)
sex
Site of siliconeadministration
Serum Calcium(mg/dL)
1,25-OH vitaminD(pg/mL)
Treatmentreceived
Overalloutcome
Kozeny, et al. (1984)
33
Transgender
Silicone injections to face, breasts and both hips
14.7
85.0
Hydration and steroids
Serum calcium improved while on steroid, but increased after it was stopped
Singapuri, et al. (2010)
49
Female
silicone injections to gluteal region
14.6
NA
Hydration, bisphosphonates and steroids
Serum calcium stabilized
Ogbuagu, et al. (2010)
38
Female
Silicone breast implants; silicone injections to lips, hip and breasts
14.0
51.0
NA
NA
Ogbuagu, et al. (2010)
48
Transgender
Silicone injections to hips, face and breasts
11.8
63.0
NA
NA
Schanz, et al. (2012)
72
Female
Topical silicone applied over face and neck with transdermal ultrasound for wrinkles removal
12.1
39.0
Steroids
Serum calcium normalized
Agrawal, et al. (2013)
45
Transgender
Bilateral breast implants and silicone injections to buttocks
13.1
147.0
Hydration and steroids
Serum calcium normalized
Camuzard, et al. (2014)
63
Female
Silicone injections to buttocks and hips
13.0
65.0
Hydration, bisphosphonates and steroids
No improvement in serum calcium, patient refused surgical treatment
Visnyei, et al. (2014)
40
Transgender
Silicone injections to thigh and gluteal region
12.3
47.0
Hydration, bisphosphonates and steroids
Initial improvement in serum calcium, but noncompliance resulted in elevation of serum calcium
Edwards, et al (2015)
50
Female
Silicone injections to gluteal region
17.3
71.0
Steroid and pentoxiphylline; surgical removal of granulomas
Steroid and pentoxiphylline did not help; surgical removal of granulomas normalized serum calcium
Edwards, et al. (2015)
NA
Female
Silicone injections to gluteal region
11.5
89.0
Steroids and surgical excision of silicone granulomas
Surgical excision improved serum calcium levels
Melnick et al. (2016)
41
Female
Silicone injections to buttocks
13.5
84.0
IV hydration, pamidronate
Serum calcium improved at one year followup
Rodriguez, et al. (2017)
74
Female
Silicone breast implants
14.0
NA
Hydration, calcitonin and removal of breast implants
Improvement in serum calcium
Noreña, et al. (2017)
40
Female
Silicone injections to gluteal region
13.0
69.1
Hydration, calcitonin, bisphosphonates, sevelamer, chloroquine, and steroids
No improvement in serum calcium, patient died from complications of hypercalcemia
Hamadeh, et al. (2018)
35
Male
Silicone injections to shoulder, arms and forearms
13.1
19.3
Mass excision; hydration, and tapering course of steroids (40 mg daily for three weeks, tapered by 5 mg weekly thereafter)
Improvement in serum calcium
Dangol, et al. (current case) (2018)
67
Female
Silicone breast implants
18.4
290.7
Hydration, calcitonin, bisphosphonate and steroids
No improvement in serum calcium; multiple admissions with hypercalcemia and its complications
NA = not available. Across the series, normal range for serum calcium was 8.2 – 10.3mg/dl. Across the series, normal range for 1, 25-OH vitamin D was 15.0 – 86.5 pg/ml.
