Calciphylaxis and Ulcerative Lesions of Bilateral Nipple–Areolar Complex Due to Alcoholic Liver Disease

Abstract

When faced with eczematous lesions involving the nipple–areolar complex (NAC), Paget's disease is assumed to be the diagnosis, anything else being considered a “Zebra” necessitating its exclusion on pathology. A middle-aged lady presented with synchronous asymmetrical ulceration of bilateral NAC with pleomorphic calcifications on mammography and simultaneous extensive vascular calcification in bilateral breasts that suggested systemic cause. Calciphylaxis is a rare diagnosis occurring usually due to underlying end-stage renal disease or hyperparathyroidism. There are very few case reports of calciphylaxis due to alcoholic liver disease and no cases to the best of our knowledge involving NAC. We report an extremely rare case of breast and NAC calciphylaxis due to alcoholic liver disease, highlighting need to consider benign etiology when bilateral involvement is present.

Keywords

breast - calciphylaxis - nipple–areolar complex - Paget's disease

Authors' Contribution

Anamika Jha was involved in conceptualization, definition of intellectual contents, literature search, manuscript preparation, and manuscript editing and review. Shreya Shrivastav was involved in conceptualization, definition of intellectual contents, literature search, and manuscript editing and review. K Akhilesh Kasyap was involved in literature search, manuscript preparation, and manuscript editing and review. Anamika Jha has provided guarantee for this manuscript.

Publikationsverlauf

Artikel online veröffentlicht:
01. Mai 2022

• References

• 1 Novotny AG, Simpson AB, Kral MA. et al. Calciphylaxis of the postmenopausal female breast: an uncommonly encountered mimic of carcinoma. Case Rep Pathol 2017; 2017: 4541620
• 2 Xie B, Zheng H, Lan H, Cui B, Jin K, Cao F. Synchronous bilateral Paget's disease of the breast: a case report. Oncol Lett 2012; 4 (01) 83-85
• 3 Buscher K, Gabriëls G, Barth P, Pavenstädt H. Breast pain in a patient on dialysis: a rare manifestation of calcific uraemic arteriolopathy. BMJ Case Rep 2015; 2015: bcr2014207946
• 4 Thornton JJ, Dolph J. Breast necrosis: calciphylaxis a rare cause. Can J Plast Surg 2008; 16 (03) 165-167
• 5 Jeong HS, Dominguez AR. Calciphylaxis: controversies in pathogenesis, diagnosis and treatment. Am J Med Sci 2016; 351 (02) 217-227
• 6 Nigwekar SU, Kroshinsky D, Nazarian RM. et al. Calciphylaxis: risk factors, diagnosis, and treatment. Am J Kidney Dis 2015; 66 (01) 133-146
• 7 Campanino PP, Tota D, Bagnera S. et al. Breast calciphylaxis following coronary artery bypass grafting completely resolved with total parathyroidectomy. Breast J 2010; 16 (05) 544-547
• 8 Goyal S, Huhn KM, Provost TT. Calciphylaxis in a patient without renal failure or elevated parathyroid hormone: possible aetiological role of chemotherapy. Br J Dermatol 2000; 143 (05) 1087-1090
• 9 Hogge JP, Palmer CH, Muller CC. et al. Quality assurance in mammography: artifact analysis. Radiographics 1999; 19 (02) 503-522
• 10 Da Costa D, Taddese A, Cure ML, Gerson D, Poppiti Jr R, Esserman LE. Common and unusual diseases of the nipple-areolar complex. Radiographics 2007; 27 (1, Suppl 1): S65-S77
• 11 Thornton CM, Hunt SJ. Sebaceous adenoma with a cutaneous horn. J Cutan Pathol 1995; 22 (02) 185-187
• 12 Chi NTB. Case report: Malignant-type calcification of the nipple with histologic correlation. Radiol Case Rep 2019; 15 (01) 82-84
• 13 Lim HS, Jeong SJ, Lee JS. et al. Paget disease of the breast: mammographic, US, and MR imaging findings with pathologic correlation. Radiographics 2011; 31 (07) 1973-1987