Giant cell myocarditis associated with silicone. An unusual case of biomaterials pathology discovered at autopsy using X-ray energy spectroscopic techniques

Silicones, used extensively in the fabrication of medical devices because they were presumed inert and biocompatible, are now well-recognized inducers of localized granulomatous inflammation. Silicones less commonly are also associated with more complex clinico-pathologic entities. In this communication, the authors present a case of a patient on chronic hemodialysis involving tubing probably fabricated from silicone rubber who died from a giant cell myocarditis associated with silicone rubber. This case is presented to expand the interpretive paradigm of human pathology and underscores the need for pathologists to consider medical-device associated phenomena in the differential diagnosis of clinical specimens.