Hypercalcemia in Metaplastic Squamous Cell Carcinoma of the Breast

Patient: Female, 71 Final Diagnosis: Metaplastic squamous cell carcinoma of the breast Symptoms: Altered mental status • necrotic breast mass Medication: — Clinical Procedure: Mastectomy Specialty: Oncology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Metaplastic breast carcinoma is a rare entity characterized by rapid growth and heterogeneous histological features. It comprises less than 1% of all breast cancers, and no definitive treatment has yet been identified. CASE REPORT: We describe here a patient who presented with acute hypercalcemia and was found to have a large ulcerated breast mass. Once the patient’s hypercalcemia was stabilized, she underwent complete surgical resection that revealed a large, cavitary, necrotic mass measuring over 11 cm. The final surgical pathology revealed meta-plastic carcinoma with extensive squamous differentiation and ductal carcinoma in situ. At the request of her family, no additional treatment was pursued. CONCLUSIONS: While there is not a significant body of data on the pathogenesis of metaplastic breast carcinoma, it is typically hormone receptor negative and has a variable response to chemotherapy. Surgical excision is the most commonly pursued treatment.