Brustimplantatassoziierte Tumoren

Zusammenfassung

Zusätzlich zu dem anaplastischen großzelligen T-Zell-Lymphom (BIA-ALCL) werden seit einigen Jahren weitere Tumoren im Zusammenhang mit Implantaten beschrieben. Sehr selten traten Plattenepithelkarzinome (SSC) und B-Zell-Lymphome auf. Die ungeklärte Pathogenese sowie das unklare individuelle Risikoprofil bringen eine anhaltende Verunsicherung von Patienten und Ärzten mit sich. Während das BIA-ALCL gehäuft im Zusammenhang mit texturierten Brustimplantaten auftritt, wurden die anderen Tumoren auch bei glattwandiger Textur und anderen Implantatlokalisationen beobachtet. Multiple potenzielle Mechanismen werden diskutiert. Eine vermutlich multifaktorielle Genese, die zu einer chronischen Entzündungsreaktion mit konsekutiver Immunstimulation führt, scheint eine Schlüsselrolle bei der malignen Transformation zu spielen. Für eine spezifische Risikobewertung liegen bisher keine ausreichend validen Daten vor, weshalb diese zurückhaltend erfolgen muss. Dargestellt werden Inzidenz, Pathogenese und Evidenzlevel des aktuellen Wissensstands sowie eine Bewertung und Diskussion der aktuellen Literatur.

Abstract

In addition to anaplastic large T-cell lymphomas (BIA-ALCL), other implant-related tumors have been described for some years. Squamous cell carcinoma (SSC) and B-cell lymphomas occurred in very rare cases. The unexplained pathogenesis as well as the unclear individual risk profile is an ongoing source of uncertainty for patients and physicians. The pathogenesis of the tumors is still largely not understood. While BIA-ALCL occurs more frequently with textured breast implants, other tumors were also observed with smooth implants and at other implant sites. Multiple potential mechanisms are discussed. It is suspected that the etiology of a chronic inflammatory response and subsequently immunostimulation is multifactorial and appears to play a key role in the malignant transformation. Since there are currently no sufficiently valid data for a specific risk assessment, this must be done with caution. This article presents the incidence, pathogenesis, as well as the level of evidence according to the current state of knowledge, and evaluates and discusses the current literature.

Schlüsselwörter

Brustimplantat - Lymphom - BIA-SCC - Immunstimulation - texturierte Implantate - Plattenepithelkarzinom - implantatassoziierte Tumoren - BIA-ALCL

Keywords

breast implant - lymphoma - BIA-SCC - immunostimulation - textured implants - squamous cell carcinoma - implant-associated tumors - BIA-ALCL

Publikationsverlauf

Artikel online veröffentlicht:
22. März 2024

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