Complication after breast implantation in Poland syndrome.

Congenital or developmental deformities of the chest rarely cause severe functional problems in the manner of larger anomalies of the limbs. Poland syndrome is known as a variety of associated anomalies centered on the trunk and upper limbs. The authors report the case of a 28-year-old female with absence of the pectoralis major muscle and depression of the left anterior thoracic wall (sunken chest). She presented with hypoplasia of the papillary-areolar complex; her upper left limb was normal. Seven years after undergoing placement of a left-side breast prosthesis, she requested replacement of the implant because she was dissatisfied with its shape. Chest radiographs showed a chest deformity and deviation of the mediastinum to the right. After surgically removing the prosthesis, an area of costal reabsorption on the left side was seen at its site, with exposure of the parietal pericardium. The prosthesis was replaced with another of greater volume and the patient was referred to the thoracic surgery service. No cases of regional bone resorption secondary to the presence of a breast prosthesis are reported in the literature. However, it is known that compression results in bone absorption and subsequent bone remodeling. The authors therefore believe that greater attention to this possibility is needed in cases of breast prosthesis replacement among patients with Poland syndrome, by means of specific imaging studies such as computed tomography.