A 42-Year-Old Woman Undergoing a Renal Transplant Evaluation

Heather Kesler DeVore, MD; Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP; Sirhan Alvi, MBChB, MRCS(Ed), MRCS(Glasg)


May 12, 2016

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.


A 42-year-old Nigerian woman, born and raised in West Africa, recently moved to Manchester, United Kingdom, where she is to undergo a routine but extensive evaluation for a renal transplant. The patient has a history of end-stage renal disease secondary to chronic glomerulonephritis. She is currently on hemodialysis but otherwise has no other active medical conditions. At the request of her nephrologist, she has presented to an outpatient breast clinic to receive a baseline examination and screening mammography.

On a review of systems focused on the imaging study to be performed, the patient denies having any weight loss, night sweats, or fevers. Additionally, she denies any tenderness in her breasts, nipple discharge, noticeable breast lumps, or other complaints related to her breasts. Her social history is significant for her previous work as a nurse in Nigeria, where she often treated people in small villages and on farms.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.