Vasculitis and Breast Cancer: Mind the Hint

• Main Authors: Miguel Esperança-Martins, Vasco Evangelista, Salomão Fernandes, Raquel Almeida
• Format: Article
• Language: English
• Published: Karger Publishers 2021-03-01
• Series: Case Reports in Oncology
• Subjects: diffuse alveolar haemorrhage; paraneoplastic vasculitis; plasmapheresis; breast cancer
• Online Access: https://www.karger.com/Article/FullText/514729

Diffuse alveolar haemorrhage related to an anti-neutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis is an extremely rare form of presentation of breast cancer. Here we report the case of a 77-year-old woman with a histological diagnosis of a papillary ductal carcinoma of the breast presenting with a diffuse alveolar haemorrhage secondary to a perinuclear ANCA-associated vasculitis. To our knowledge, this is the first case ever reported of a diffuse alveolar haemorrhage related to an ANCA-associated small vessel vasculitis as a form of presentation of breast cancer. The therapeutic approach of this paraneoplastic vasculitis included the use of corticosteroids and plasmapheresis, a very useful technique to remove endothelial aggressors (circulating antibodies) as a strategy to earn time for a proper therapeutic decision specifically directed for disease modification, but that can also be associated with several severe adverse effects, which are illustrated in our case.