{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390004222630222080.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.3804/jjabcs.29.129"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/jjabcs/29/2/29_129/_pdf"}},{"identifier":{"@type":"NAID","@value":"130007920679"}}],"dc:title":[{"@language":"en","@value":"A case of an intracapsular rupture of breast implant concomitant with left breast cancer diagnosed by the linguine sign on preoperative CT"},{"@language":"ja","@value":"CT での linguine sign によりインプラント被膜内破裂を診断できた豊胸術後乳癌の１例"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"A 67-year-old woman was admitted to our department with suspected left breast cancer. She had a past history of undergoing bilateral mammoplasty using silicone implants in her thirties. Computed tomography showed multiple curvilinear floating lines in the silicone implant on the left side, which is known as the linguine sign, and indicates complete collapse of the implant shell. Ultrasonography of the left breast at the first consultation showed the stepladder sign, which is represented by multiply folded shells floating in silicone gel. Since the patient was also diagnosed as having stage1 breast cancer, a partial mastectomy with sentinel lymph node biopsy was performed, followed by bilateral breast implant removal. When the fibrous capsule in the left breast was released, viscous silicone gel with some torn pieces of shell were drained, whereas the right breast implant was intact. Histopathologically, no piece of silicone was found in the resected breast tissue or lymph nodes. Breast implant rupture is classified as intracapsular or extracapsular. Since intracapsular rupture usually occurs without apparent symptoms, it is often detected by chance during radiological studies, as in this case. Surgical removal of the silicone gel in these cases is not so difficult. On the other hand, in the case of extracapsular rupture, silicone gel invading the breast parenchyma and lymphatics causes several inflammatory changes, and total removal of the silicone is nearly impossible. It is essential to diagnose implant rupture as early as possible by breast imaging studies. Since several diagnostic images typical of implant rupture have been reported in the literature, a breast physician should be familiar with these changes for early diagnosis."},{"@language":"ja","@value":"症例は６７歳女性。３０数年前に豊胸目的に両側乳房インプラント挿入の既往。左乳房上外側腫瘤の主訴で当科受診。左 C 領域に１．５cm 大の硬結を認めた。豊胸部に左右差はなかった。乳房超音波検査で左 C 領域に halo を伴う１．６cm 大の不整形低エコー腫瘤，左インプラント内に複数の膜様構造物を確認。CT で左インプラントの内部に波打つ膜様構造物があり linguine sign と考えた。インプラント被膜内破裂と診断した。乳腺腫瘍は stage I 乳癌と診断され，初診後２か月で手術を施行した。右乳房では破損のないインプラントを摘出。左乳房では左乳房部分切除術＋センチネルリンパ節生検（Bp＋SN）を施行後，線維性被膜を切開し，薄黄色透明で粘稠なゲルおよび破断したシェルを排出，洗浄し手術を終了した。乳房インプラント破裂は被膜内破裂と被膜外破裂に分類され，前者では比較的症状が軽く，本症例のように画像検査で偶然発見される場合も多い。流出したシリコンの外科的摘除も比較的容易である。画像所見としてはゲルのなかを破損したシェルが浮遊する像である linguine sign が有名で，MRI が最も感度が高いとされるが，本症例では CTで確認された。超音波検査の有用性も高く，折りたたまれたシェルが階段状に撮像されるstepladder sign が本症例でも確認された。一方，被膜外破裂の場合は乳腺内・リンパ網内に浸入したシリコンが多彩な症状を呈し完全に摘出するのは困難とされる。早期に画像的にインプラント破裂を診断し，摘出することが重要と考えられる。"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410004222630222080","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000410316933"}],"foaf:name":[{"@language":"en","@value":"Yonezawa Kei"},{"@language":"ja","@value":"米沢 圭"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"静岡市立静岡病院・外科"},{"@language":"en","@value":"Department of Surgery, Shizuoka City Shizuoka Hospital"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09180729"},{"@type":"EISSN","@value":"18826873"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Nyugan Kenshin Gakkaishi (Journal of Japan Association of Breast Cancer Screening)"},{"@language":"ja","@value":"日本乳癌検診学会誌"},{"@language":"en","@value":"J.Jpn. Assoc.Breast Cancer Screen."},{"@language":"ja","@value":"日乳癌検診学会誌"},{"@language":"en","@value":"J. Jpn. Assoc. Breast Cancer Screen. Journal of Japan Association of Breast Cancer Screening"}],"dc:publisher":[{"@language":"en","@value":"Japan Association of Breast Cancer Screening"},{"@language":"ja","@value":"特定非営利活動法人　日本乳癌検診学会"}],"prism:publicationDate":"2020","prism:volume":"29","prism:number":"2","prism:startingPage":"129","prism:endingPage":"134"},"reviewed":"false","url":[{"@id":"https://www.jstage.jst.go.jp/article/jjabcs/29/2/29_129/_pdf"}],"availableAt":"2020","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=linguine%20sign","dc:title":"linguine sign"},{"@id":"https://cir.nii.ac.jp/all?q=computed%20tomography%EF%BC%88CT%EF%BC%89","dc:title":"computed tomography（CT）"},{"@id":"https://cir.nii.ac.jp/all?q=stepladder%20sign","dc:title":"stepladder sign"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%B9%B3%E6%88%BF%E3%82%A4%E3%83%B3%E3%83%97%E3%83%A9%E3%83%B3%E3%83%88","dc:title":"乳房インプラント"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%A2%AB%E8%86%9C%E5%86%85%E7%A0%B4%E8%A3%82","dc:title":"被膜内破裂"},{"@id":"https://cir.nii.ac.jp/all?q=linguine%20sign","dc:title":"linguine sign"},{"@id":"https://cir.nii.ac.jp/all?q=computed%20tomography%EF%BC%88CT%EF%BC%89","dc:title":"computed tomography（CT）"},{"@id":"https://cir.nii.ac.jp/all?q=stepladder%20sign","dc:title":"stepladder sign"},{"@id":"https://cir.nii.ac.jp/all?q=breast%20implant","dc:title":"breast implant"},{"@id":"https://cir.nii.ac.jp/all?q=intracapsular%20rupture","dc:title":"intracapsular rupture"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360011145168664576","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Sentinel lymph node biopsy following prior augmentation mammaplasty and implant rupture"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011146119106304","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Sentinel lymph node biopsy in breast cancer patients with previous breast augmentation surgery"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292618891541760","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The Linguine Sign"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574095015227008","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Ten-Year Results From the Natrelle 410 Anatomical Form-Stable Silicone Breast Implant Core Study"}]},{"@id":"https://cir.nii.ac.jp/crid/1362544421170670336","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Longitudinal Ultrasound Study of Breast Implant Rupture Over a Six-Year Interval"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825894925299840","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Comparative Silicone Breast Implant Evaluation Using Mammography, Sonography, and Magnetic Resonance Imaging"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825895033538176","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Breast-conserving therapy and sentinel lymph node biopsy are feasible in cancer patients with previous implant breast augmentation"}]},{"@id":"https://cir.nii.ac.jp/crid/1362825895876947712","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Incidence of breast implant rupture in a 12-year retrospective cohort: Evidence of quality discrepancy depending on the range"}]},{"@id":"https://cir.nii.ac.jp/crid/1363670319444577664","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Sentinel lymph node biopsy in a patient with ruptured poly implant prothese (PIP) implants: A case report"}]},{"@id":"https://cir.nii.ac.jp/crid/1363951795278695040","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2008065318"},{"@type":"CROSSREF","@value":"10.3804/jjabcs.29.129"},{"@type":"CIA","@value":"130007920679"},{"@type":"OPENAIRE","@value":"doi_dedup___::365b6f80588a1a96a0e016d5e1558225"}]}