CTICasesSilicone Embolization Syndrome from Penile Injection
Imaging findings
CT demonstrates symmetric bilateral ground-glass opacities with slight upper lobe predominance in a young man. The distribution is unexpected for hematogenous spread, which is typically lower lobe predominant; however, the patient history reveals that he had been injecting self-described medical-grade silicone into his penis for cosmetic enlargement for approximately 18 months, inadvertently hitting a vein and causing intravascular silicone injection 7 days prior to CT. The right heart appears normal sized without pulmonary hypertension.
Key takeaways
Silicone embolization syndrome results from intravascular injection of liquid silicone, producing a chemical pneumonitis from micro-emboli occluding pulmonary capillaries and triggering a foreign body inflammatory response. The CT pattern of bilateral ground-glass opacity resembles fat embolism syndrome. The upper lobe predominance in this case may reflect the patient's supine position during injection or depletion of lower lobe vascularity from prior micro-embolization over 18 months. Unlike massive fat embolism, this relatively small intravascular event did not cause right heart strain. Silicone likely persists in the lungs as granulomas and does not fully clear.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Intimal Sarcoma of the Pulmonary ArteryNeoplastic
- Massive Unilateral Pulmonary Embolism Mimicking Pulmonary Artery SarcomaVascular
- Plexiform Neurofibroma of the MediastinumNeoplastic
- Milk of Calcium Pleural CollectionsOther
- Niemann-Pick Disease Type B — Septal Thickening and Crazy PavingMetabolic
- Achalasia with Aspiration Lipoid Pneumonia and Crazy PavingOther
- Angio-Invasive Aspergillosis with Air Crescent Sign (Doll's Eyes)Infection
- Lymphoid Interstitial Pneumonia (LIP) with Concurrent MALT Lymphoma in Sjogren's SyndromeNeoplastic
See all cases from September 8, 2017 →
Related Exposure cases
- Acute Inhalation Injury from Mineral Oil Smoke Simulant in a Firefighter
- Hookah Smoking-Induced Foreign Body Granulomatous Bronchiolitis
- Methamphetamine-Induced Pulmonary Arterial Hypertension and Restrictive Allograft Syndrome
- Intravenous Metallic Mercury Embolization
- Dab Lung (Butane Hash Oil-Induced Bronchiolitis and Organizing Pneumonia)
- Free Silicone Breast Injections with Calcified and Non-Calcified Granulomas