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Acute Inflammatory Response of the Male Breasts Secondary to Self-injection of Petroleum Jelly: A Case Report

Ming Chen, MD, PhD, Chandana Yalamanchili, MD, James Hamous, MD, Mary A. Piskun, MD, Brian Weis, MD, PhD
Volume: 101 Issue: 4 April, 2008

Abstract:

The injection of liquid foreign materials such as petroleum jelly and paraffin oil was used as an early medical intervention for the augmentation of body contour in the late 19th century. These practices were associated with severe late onset complications and they have been abandoned by plastic surgeons today. This article discusses a male-to-female transsexual patient with an acute inflammatory response with early sclerosing lipogranuloma of breasts associated with the self-injection of large amounts of petroleum jelly. The inflammation is successfully controlled with the early administration of prophylactic broad-spectrum antibiotics, steroids, and nonsteroid anti-inflammatory agents followed by a subcutaneous mastectomy. The importance of medical education and psychology counseling is discussed.


Key Points


* There has been a good body of evidence in the literature that the injection of petroleum products, such as petroleum jelly and paraffin oil, can cause chronic granulomatous changes many years after administration.


* The acute inflammatory response to petroleum injection, however, is an uncommon complication and can be very dramatic, as described in this case.


* There has not been an established protocol for the management of acute inflammatory response after subcutaneous injection of petroleum products.


* It is important for physicians to be alert to recognize those patients at risk to practice body modification outside of a medical setting.

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References:

1. Gersuny R. Über eine subcutane Prothese. Z Heilkunde 1900;1:199.
 
2. Gersuny R. Harte und weiche Paraffinprosthesen. Zentralbl Chir 1903;30:1.
 
3. Eckstein H. Über subkutane und submuköse harte Paraffin-Prosthesen. Dtsch Med Wochenschr 1902;28:573.
 
4. Quenu J, Perol E. Paraffinomas of the penis. Int Abstr Surg 1948;86:174.
 
5. Symmers WS. Silicone mastitis in “topless” waitresses and some other varieties of foreign-body mastitis. Br Med J 1968;3:19–22.
 
6. Ho WS, Chan AC, Law BK. Management of paraffinoma of the breast: 10 years’ experience. Br J Plast Surg 2001;54:232–234.
7. Wiwanitkit V. Penile injection of foreign bodies in eight Thai patients. Sex Transm infect 2004;80:546.
 
8. Rollins CE, Reiber G, Guinee DG Jr, et al. Disseminated lipogranulomas and sudden death from self-administered mineral oil injection. Am J Forensic Med Pathol 1997;18:100–103.
 
9. Davis BF. Paraffinoma and wax cancer. JAMA 1920;75:1709–1711.
 
10. Kay SP, Saad MN. Paraffinoma of the male breast: a case report. Br J Plat Surg 1983;36:522–523.
 
11. Di Benedetto G, Pierangeli M, Scalise A, et al. Paraffin oil injection in the body: an obsolete and destructive procedure. Ann Plast Surg 2002;49:391–396.
 
12. Cabral AR, Alcocer-Varela J, Orozco-Topete R, et al. Clinical, histopathological, immunological and fibroblast studies in 30 patients with subcutaneous injections of modelants including silicone and mineral oils. Rev Invest Clin 1994;46:257–266.
 
13. Wong CH, Khin LW, Heng KS, et al. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004;32:1535–1541.
 
14. Pennisi VR. Obscure carcinoma encountered in subcutaneous mastectomy in silicone- and paraffin-injected breasts: two patients. Plastic Reconstr Surg 1984;74:535–538.
 
15. Ciancio SJ, Coburn M. Penile salvage for squamous cell carcinoma associated with mineral oil injection. J Urol 2000;164:1650.
 
16. Ooi GC, Peh WC, Ip M. Migration and lymphatic spread of calcified paraffinomas after breast augmentation. Australas Radiol 1996;40:404–407.
 
17. Meza-Perez A, Rodiguez Patino E. Gigantomastia secondary to mineral oil injection. A case report. Gac Med Mex 2004;140:215–218.
 
18. American Society of Plastic Surgeons. 2000/2005/2006 National plastic surgery statistics: cosmetic and reconstructive procedure trends. 2007. Available at: http://plasticsurgery.org/media/statistics/loader.cfm?url=/commonspot/security/getfile.cfm&pageID=1931. Accessed February 27, 2008.

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