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Calciphylaxis associated with metastatic breast carcinoma
D N Mastruserio1, E Q Nguyen, T Nielsen
1Division of Dermatology, The Ohio State University, Columbia, OH 43210, USA.
Journal of the American Academy of Dermatology
|July 30, 1999
Summary
Calciphylaxis, a rare vascular disorder causing skin necrosis, typically affects patients with end-stage renal disease. This case highlights calciphylaxis in metastatic breast cancer without kidney or parathyroid issues, broadening diagnostic considerations.
Area of Science:
- Vascular Medicine
- Oncology
- Nephrology
Background:
- Calciphylaxis is a rare, severe condition characterized by calcification of small and medium blood vessels, leading to progressive skin necrosis.
- It is most commonly observed in patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism.
- However, calciphylaxis has also been linked to primary hyperparathyroidism, malignancy-associated hypercalcemia, and end-stage liver disease.
Observation:
- This report details an unusual case of calciphylaxis.
- The patient presented with metastatic breast carcinoma but lacked concurrent renal or parathyroid disease.
- This presentation is rare, with only one prior report of calciphylaxis in a patient with metastatic breast adenocarcinoma and hypercalcemia.
Findings:
- The case involves calciphylaxis associated with osteolytic, metastatic breast cancer.
- This finding is significant as it represents the second documented instance of this specific association.
- It underscores that calciphylaxis can occur in the absence of the typical triggers of ESRD and hyperparathyroidism.
Implications:
- While ESRD with secondary hyperparathyroidism is the most frequent cause of calciphylaxis, this case broadens the differential diagnosis.
- Clinicians should consider calciphylaxis in patients with altered calcium metabolism, even without established renal or parathyroid disease.
- This emphasizes the need for a comprehensive evaluation of calcium metabolism in diverse clinical contexts presenting with vascular calcification and necrosis.