ABSTRACT
Pulmonary alveolar (phospholipo)proteinosis (PAP) is a rare lung disease, predominantly autoimmune in nature. This case report describes a patient with insidious dyspnoea since 5 years and a milky appearance of her bronchoalveolar fluid, leading to the diagnosis of PAP. The onset of symptoms coincided with an exchange of her silicone breast implants. Giant cell reaction in axillary adenopathies pointed towards silicone leakage. Adjuvants, such as silicone, might boost pre-existing antigen reactions of the immune system, potentially leading to autoimmune phenomena.
Subject(s)
Autoimmune Diseases/diagnosis , Breast Implants/adverse effects , Pulmonary Alveolar Proteinosis/diagnosis , Silicone Gels/adverse effects , Autoimmune Diseases/etiology , Female , Granuloma, Giant Cell/pathology , Humans , Middle Aged , Pulmonary Alveolar Proteinosis/etiologyABSTRACT
We present a case of a cervical chordoma extending from C3 to C6, treated by surgical resection followed by reconstruction in two stages with a vascularised fibular strut graft anteriorly and fibular allografts posteriorly. The goal was to achieve a stable reconstruction without any metal hardware to allow for increased accuracy of the adjuvant radiotherapy. The advantages of a vascularised fibula flap to realise this are discussed.
