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⁶⁷Ga uptake after cosmetic augmentation with silicone in HIV-infected patient with unexplained hypercalcemia: utility of SPECT/CT.

A 56-year-old HIV-infected man underwent Ga scintigraphy because of unexplained hypercalcemia, elevated calcitriol, and concern for chronic granulomatous disease, including tuberculosis. Although no abnormalities were identified to indicate sarcoidosis or tuberculosis, increased radiotracer accumulation in the face and gluteal region was observed. On questioning, the patient revealed a 3-year history of liquid silicone use for soft-tissue augmentation of the face and buttocks. After SPECT/CT imaging, the etiology of the patient’s hypercalcemia was attributable to siliconeinduced granulomatosis. We present this case to highlight the appearance of Ga uptake on SPECT/CT after cosmetic augmentation with liquid silicone in the face and buttocks and silicone-induced granulomatosis as a cause of unexplained elevated vitamin D and hypercalcemia.