title: Calciphylaxis of the Breast: A Case Report and Literature Review.
abstract: Calciphylaxis, or calcific uremic arteriolopathy, is a rare but particularly morbid condition involving systemic medial calcification of arterioles causing ischemia and subsequent tissue necrosis. Although most commonly occurring over the abdomen and proximal extremities, calciphylaxis can present on nearly any skin surface with a tendency toward areas of increased adiposity. We report a case of a 53-year-old female with end-stage renal disease who presented with bilateral palpable breast masses and overlying skin changes. Diagnostic mammography and percutaneous biopsy of the lesion facilitated the diagnosis of calciphylaxis and she was treated with medical therapy, local wound care, and eventual tissue extirpation. Due to the morbidity attributed to calciphylaxis and associated wound complications, surgical extirpation is at times unavoidable. Once malignancy has been excluded, we recommend nonoperative management with prompt referral to Nephrology for medical optimization, reserving surgical debridement for nonhealing wounds and superinfection.
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hall
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Lori F
authors.initials: LF
authors.lastname: Gentile
authors.affiliation: Department of Pathology, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Lizette V
authors.initials: LV
authors.lastname: Duckworth
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Christiana M
authors.initials: CM
authors.lastname: Shaw
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.|Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Dhruv
authors.initials: D
authors.lastname: Singhal
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Lisa R P
authors.initials: LR
authors.lastname: Spiguel
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D002115:Calciphylaxis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents
keywords: ESRD; arteriolopathy; breast; calcific; calciphylaxis; uremic