Inflammatory breast cancer and secondary Pure Red Cell Aplasia.

Pure Red Cell Aplasia (PRCA) is a disorder charac-terized by anemia with almost complete absence of red-cell precursors but normal platelet and white blood cell precursors. It is a recognized complication of mali-gnancies, particularly Large Granulocyte Lymphomas, CLL, Hodgkins Lymphoma and thymomas [1]. PRCA has also been associated with other solid organ malig-nancies, including breast cancer although the occur-rence is very rare [2,3]. Treatment of PRCA is usually based on oral cor-ticosteroids and cyclosporine, although other immu-nosuppressive agents have been used successfully [4]. Relapse, however, is common and often prolonged courses of immunosuppression are required [5]. There have been a number of cases where treatment of an underlying malignancy has resulted in sustained remis-sion of the PRCA [3,6]. We will describe a case of breast cancer associated with PRCA, in which treatment of the underlying breast cancer in conjunction with brief course of oral pred-nisolone has caused lasting remission. A 54-year-old lady presented with a 10 cm left fun-gating infl ammatory breast mass and fevers (Figure 1). Biopsy confi rmed a basal-like invasive ductal carci-noma HER-2 negative ER/PR negative. CT scanning on presentation revealed mild left-sided lymphade-nopathy suspicious for locally advance disease. Whole body bone scan did not reveal any evidence of meta-static disease. The initial hemoglobin (Hb) was 72 g/l. The white cell count was 21.7 9 10 (neutrophils 18.6 10