Pleomorphic calcifications (crushed stone appearance) and some type of casting associated with ductal carcinoma in situ

Case contributed by Valerio Giacalone

Presentation

Patient undergoing mammography prevention screening.

Patient Data

Age: 45 years
Gender: Female

The group of non-specific calcifications remained unchanged. After six months, however, a new group of pleomorphic calcifications (flattened stone morphology) and some casting-type calcifications appeared in a median position, malignant characteristics.

A grouping of irregular, amorphous and non-specific calcifications can be seen in the mid-external quadrant of the right breast.

Case Discussion

This case illustrates the evolution at six months of a group of non-specific calcifications in the absence of suspicious opacities. The group of non-specific calcifications remained unchanged. After six months, however, a new group of pleomorphic calcifications (crushed stone morphology) and some casting type calcifications appeared in a median position. On stereotactic biopsy, the result was ductal carcinoma. Magnetic resonance imaging (not shown) was performed and found a higher proportion of pathological tissue than mammographic examination.

Often suspicious mammographic features are only the "tip of the iceberg" and underestimate the true extent of the tumor; MRI can help us detect the true extent of the disease, as in this patient's case.

Today, compared to the past, it is preferable to biopsy a group of amorphous calcifications immediately, without waiting for the evolution in the following six months.

 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.