Sporadic late-onset nemaline myopathy in a patient with silicone breast implants

We present the case of a woman who, in association with a rupture of a breast implant, a few years later, developed fibromyalgia together with a myofibrillar myopathy with abundant cytoplasmic rods. Such myopathy, despite microscopic inflammatory changes and the increased ANA and anti-ENA (anti-CenpB), showed a poor inflammatory character and was highly suggestive of sporadic late onset nemaline myopathy (SLONM). SLONM is a sporadic myopathy described in association with MGUS or, less frequently, multiple myeloma, or in association with autoimmune disorders, such as Sjogren's syndrome, systemic lupus erythematosus and dermatomyositis. To our best knowledge, this type of myofibrillar myopathy has been not previously described neither in association to Silicone implant incompatibility syndrome (SIIS) nor to immunoinflammatory mechanisms potently triggered by silicone.