Unilateral breast swelling mimicking malignancy: an uncommon presentation of central venous obstruction in a hemodialysis patient

Abstract

Central venous obstruction is an important vascular complication that may occur in patients with end-stage renal disease undergoing long-term hemodialysis, particularly after repeated central venous catheter placement. Although it usually presents with swelling of the ipsilateral upper limb, uncommon clinical manifestations may lead to diagnostic confusion. We report the case of a 65-year-old woman on maintenance hemodialysis who developed progressive unilateral breast swelling and erythema. Because these findings can mimic inflammatory or malignant breast disease, the patient underwent radiological evaluation and several biopsies to exclude malignancy. All investigations showed no evidence of cancer. Further assessment revealed impaired central venous drainage related to previous catheter insertions. This case highlights an unusual presentation of central venous obstruction and emphasizes the need to consider vascular causes in dialysis patients presenting with unexplained unilateral breast swelling.