"Serpent" in the breast

Dracunculus medinensis better known as guinea worm is the longest nematode infecting humans. Mature female worms migrate along subcutaneous tissue to reach the skin below the knee forming a painful ulcerating blister. Calcified male worm can occasionally be found in the retro peritoneum. Finding of a calcified worm in the breast tissue is very rare. We report a case of a fit and well African lady who was found to have a calcified guinea worm in the breast on a mammographic examination for investigation of a breast lump.

A 51 years old female, presented in the surgical outpatient clinic with a painless irregular lump under the right nipple on clinical examination. There were no skin changes, nipple discharge or axillary lymphadenopathy. Mammogram showed a calcified Guinea worm.

No treatment was offered and a repeat mammogram after one year showed the same findings. She was discharged from the clinic without any follow up and will be screened routinely as per national guidelines

Guinea worm can be included in the differential diagnosis of the breast lump especially in the endemic areas although the finding remains very rare.