Parasitic invasion by a nematode worm could be mistaken for cancer in women presenting with breast lumps, researchers claim after diagnosing calcified filariasis in a woman with bilateral breast lumps.
"Because patients with these parasites present with lumps in the breast, the findings are a cause for concern, since they are often clinically suspected to be malignant," Hatem Alkadhi and Elisabeth Garzoli, from the Institute of Diagnostic Radiology in Zurich, Switzerland, observe.
The 23-year-old patient had emigrated from Cameroon 2 years before she presented to the institute with bilateral breast lumps. While her history was unremarkable, physical examination confirmed the presence of several nonpainful, mobile, firm lumps in both breasts, without axillary lymph node involvement.
Mammography showed multiple creeping, tubular calcifications in both breasts, characteristic of calcified filariasis.
Filarial infection of the breast is not rare, explain the authors. "The larvae enter the lymphatic vessels of the mammary gland, causing lymphangitis, fibrosis, and disruption of lymphatic drainage." In late, inactive phases, the larvae appear on mammography as serpiginous calcifications.
Although a global campaign to eliminate filariasis is currently ongoing, the team warns that the condition is likely to be encountered increasingly frequently on mammography examination as immigration from areas where filariasis is endemic to developed countries continues to rise.