What’s the Worm? Breast Calcifications in a Patient from Cameroon

Case Report

Austin J Clin Case Rep. 2016; 3(6): 1108.

What’s the Worm? Breast Calcifications in a Patient from Cameroon

Brody MB*, Tuite C and Evers KA

Department of Diagnostic Imaging, Fox Chase Cancer Center, USA

*Corresponding author: Marion B Brody, Department of Diagnostic Imaging, Fox Chase Cancer Center, Philadelphia, PA, USA

Received: November 08, 2016; Accepted: December 28, 2016; Published: December 30, 2016

Abstract

Determining the significance of calcifications seen on mammogram can be a vexing problem for radiologists. Identifying benign morphologies can avoid unnecessary work-ups and procedures. We describe breast calcifications typical for filarial infection seen on screening mammogram in a patient who is a native of Cameroon. Filariasis is the most common parasitic infection affecting the breast, and is transmitted by insect vectors. It is most prevalent in parts of Africa, Asia, and India. In general, breast calcifications due to filarial infection in Westernized countries are seen in asymptomatic patients from endemic areas, and are the result of treated, chronic, or “burned out” infection. The epidemiologic, mammographic, and clinical and features of filarial infection are discussed.

Keywords: Filariasis; Breast calcifications; Mammogram

Case Presentation

A 68 year old female was referred by her primary care physician for routine screening mammography on our mobile mammography unit. The patient is a native of West Africa. She reported that her prior mammograms were performed in Cameroon and were not obtainable for comparison. At the time of screening, she was asymptomatic. She denied a family history of breast cancer, or a personal history of hormone use, prior breast procedures, or reduction surgery. Routine mammographic views show calcifications bilaterally. In the lower inner left breast (Figure 1a), there are thick linear calcifications with lucent centers. In the subareolar right breast (Figures 1b & 1c), there are thick linear calcifications arranged in a serpiginous configuration. In the upper inner right breast and central outer left breast (Figures 1d &1e), there are fine linear calcifications arranged in a coiled configuration. In the upper outer right breast, there are more tightly grouped thick linear calcifications, for which the patient was called back for additional imaging. On magnification imaging (Figure 2), this group is comprised of monomorphic thick linear calcifications, representing fragments of similar-appearing calcifications in other areas of the breasts.

Citation: Brody MB, Tuite C and Evers KA. What’s the Worm? Breast Calcifications in a Patient from Cameroon. Austin J Clin Case Rep. 2016; 3(6): 1108. ISSN:2381-912X