Mammary calcifications in a diabetic patient. Description of a case

Clinical History

A 72 years-aged patient comes to our observation for undergoing a mammographic control examination, having effected the previous investigation two years before in another centre. The mammographic examination shows bilaterally the presence of linear calcifications, like a parallel track and compact ones, respectively of arterial and ductal pertinency.

Imaging Findings

The report of calcifications, according to the mammographic examination, is rather frequent, above all in association with benign or malignant pathology. We present a case of arterial and ductal calcifications found out in a patient suffering from diabetes mellitus A 72 years-aged patient comes to our observation for undergoing a mammographic control examination, having effected the previous investigation two years before in another centre. The mammographic examination shows bilaterally the presence of linear calcifications, like a parallel track and compact ones, respectively of arterial and ductal pertinency. Such calcifications show a tortuous course with radial disposition from the nipple to the breast periphery, in absence of suspected radiologic images and of irregular microcalcifications, not even in absence of a clinical symptomatology. The comparison with the previous examination points out an increase of the radiopacity and of the quantity of the calcium deposits described. The patient refers being cardiopathic, suffering from diabetes mellitus for about 10 years.

Discussion

The radiographic report of arterial and ductal calcifications is frequent in diabetic patients and rises proportionally to the age and the duration of the disease (3,4). Among the most interesting arterial districts we can remember internal carotids, renal, aorta, pelvic and lower limbs arteries; sometimes it is possible to notice mammary arterial calcifications although this report can also be present during renal affections and secondary iperparatiroidism (2). As regards the arterial calcifications, the anatomopathologic substrate is the calcification of the media (Monckeberg sclerosis). According to the mammographic examination the calcifications of the media appear thin, regular and diffused; they concern the whole circumference of the artery giving a typical “ring” or “ “blowpipe” aspect; on the contrary the intimal calcifications are coarse and discontinuous (1). The ductal calcifications, on the other hand, involve the walls for their whole thickness . The intraductal calcium associated fallout gives an opacity of fibrotic aspect to the ducts which can become dilated. The vascular and ductal calcifications rise with the age and, in larger measure, in diabetic women, in comparison with the non diabetic ones. Nevertheless the mammographic report of calcifications, occasional at times, does not represent a valid principle to suspect the diabetic pathology but surely is an unmistakable report of benignity (1). V

Differential Diagnosis List

Final Diagnosis

VASCULAR AND DUCTAL CALCIFICATIONS

URL:	https://eurorad.org/case/99
DOI:	10.1594/EURORAD/CASE.99
ISSN:	1563-4086