Calciphylaxis of the Postmenopausal Female Breast: An Uncommonly Encountered Mimic of Carcinoma

Abstract

Calciphylaxis is a serious medical condition that is typically associated with end-stage renal disease and presents as the sequelae of calcifications in arterioles with subsequent ischemia of affected tissues. Classically, calciphylaxis produces ulcerated and necrotic skin lesions. These may be biopsied to aid in confirmation of the diagnosis. Herein we report a case of a large necrotic breast lesion in the clinical setting of calciphylaxis, and we emphasize that a multidisciplinary approach to diagnosis and management is important to avoid unnecessary oncological resection.

Breast fat necrosis secondary to warfarin‐induced calciphylaxis, a rare mimicker of breast cancer: A case report and a review of literature

“…In 2017, Yung‐Hsu Yu et al reported 3 cases of warfarin‐induced nonuremic calciphylaxis and found another 15 cases in the literature. Of all 18 cases, none of which were located in the breast 3,6 …”

“…However, one of the extremely rare causes of fat necrosis is calciphylaxis, which is a calcification of small‐ and medium‐sized arteries leading to the development of intramural thrombus and subsequent ischemia. Calciphylaxis has been reported in the literature to be encountered in different parts of the body like skin, kidneys, muscles, and to a lesser extent in lungs, heart, and alimentary tract 1–4 . It is classified into (A) uremia‐induced and (B) nonuremic‐induced calciphylaxis (obesity, chronic liver disorders, and drugs) 5 .…”

Bilateral breast calciphylaxis in a patient who survived earlier extensive tissue necrosis 5 years previously: A case report

“…Several pathophysiological theories are proposed [ 4 , 7 ]. Some suggest that the syndrome must be considered as the far end of a continuum of systemic vascular calcification.…”

“…Calciphylaxis should be considered in each hemodialysis patient having painful subcutaneous nodules, non-healing ulcers and/or soft tissue necrosis. Diagnosis can be confirmed via skin biopsy, but also through ultrasound, mammography, X-rays or a three-phase technetium 99 m methylene diphosphate bone scan (organs) [ 1 , [3] , [4] , [5] , 7 ].…”

“…Calciphylaxis is a clinical diagnosis although imaging or pathologic examination may be used for confirmation. A handful of cases of breast calciphylaxis were described previously [ [5] , [6] , [7] , [8] ]. However, patients recovering from a first episode of extremity calciphylaxis but developing a second one 5 years later is unique.…”