Case Report: Testicular Sarcoidosis: The Diagnostic Role of Contrast-Enhanced Ultrasound and Review of the Literature

Cinque, Antonio De; Corcioni, Beniamino; Rossi, Martina; Franceschelli, Alessandro; Colombo, Fulvio; Golfieri, Rita; Renzulli, Matteo; Gaudiano, Caterina

doi:10.3389/fmed.2020.610384

Cited by 7 publications

(9 citation statements)

References 45 publications

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“…Fewer than 0.2% of all clinically diagnosed cases of sarcoidosis have GU manifestations, but the number is as high as 5% in autopsy studies. Essentially, sarcoid affects the GU system 25 times more frequently than diagnosed [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…When differentiating sarcoidosis and testicular cancer, it’s paramount to understand that Lactate dehydrogenase (LDH) is not reliable, as sarcoidosis may cause a raised LDH as well. However, it does not cause elevations in alpha-fetoprotein (AFP) or human chorionic gonadotropin (b-HCG) [ 8 ]. Clinical findings that increase the likelihood of a benign diagnosis include Afro-Caribbean ethnicity and bilateral testicular lesions [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Testicular sarcoidosis continues to pose a multitude of diagnostic challenges and is likely an underdiagnosed entity. To compare, sarcoidosis affects the testes in fewer than 0.2% of all clinically diagnosed cases, while pulmonary manifestations are diagnosed in 90% of cases [ 8 , 10 ]. Management largely depends on the disease severity, the desire for fertility, and symptomatology [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Testicular Sarcoidosis: An Underdiagnosed Manifestation That Poses Unique Challenges

Choksi¹,

Singh²

2022

Cureus

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Testicular involvement is a rarely encountered complication of sarcoidosis. There are unique challenges involved when sarcoidosis affects the genitourinary system. These include differentiating the findings from testicular cancer, which often results in invasive procedures such as orchiectomies. It can also be a cause of secondary infertility in men. Additionally, it may also be underdiagnosed. Here, we describe a case where a patient showed a constellation of findings suggestive of sarcoidosis, along with testicular involvement at initial presentation. In this case, the diagnosis was made clinically with supporting laboratory, pathology, and ultrasound findings. The testicular findings were not biopsied, as the patient had easily accessible skin findings to confirm sarcoidosis. His testicular findings are continued to be monitored via ultrasound.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Testicular Sarcoidosis: An Underdiagnosed Manifestation That Poses Unique Challenges

Choksi¹,

Singh²

2022

Cureus

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“…Urogenital sarcoid occurs in 0.2% of clinically diagnosed cases and 5% of those diagnosed at autopsy [2,3]. Osseous sarcoidosis is another rare EM with a prevalence of 3% to 13% [2][3][4][5]. It is often underdiagnosed because of its asymptomatic nature.…”

Section: Introductionmentioning

confidence: 99%

An Atypical Case of Extrapulmonary Sarcoidosis

Shaik¹,

Sherer²,

Rhodes³

2022

Cureus

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Sarcoidosis is an idiopathic, inflammatory condition that affects nearly all organs in the body. Lungs are the most frequent and among the earliest sites for detecting it. The most common extrapulmonary manifestations involve the ophthalmic, cardiac, nervous, reticuloendothelial, cutaneous, hepatosplenic, and renal systems. These extrapulmonary manifestations of sarcoid may be misdiagnosed in the absence of the classical pulmonary features, given the high overlap of features with other chronic immunologic diseases. The diagnostic workup to differentiate sarcoid from other similar conditions is extensive, amongst which histology remains a gold standard tool for the diagnosis. Our patient presented with a chronic history of multiple vague complaints including nausea, vomiting, progressive malaise, vision changes, and weight loss. After extensive workup, a diagnosis of sarcoidosis along with multiple rare extrapulmonary involvements was made. The authors highlight essential implications including primary practice goals to avoid misdiagnosis or missed sarcoid diagnoses thus helping improve clinical outcomes in similar populations.

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“…In more than 90% of patients, sarcoidosis affects the lungs and lymph nodes; however, this multisystem disease can affect virtually any organ [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Imaging of Biliary Involvement in Sarcoidosis: Computed Tomography, Magnetic Resonance Cholangiopancreatography, and Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid-Enhanced Magnetic Resonance Imaging Findings

et al. 2021

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Sarcoidosis is a multisystem disease usually affecting the chest, hilar lymph nodes, and lungs, but can potentially involve any organ; therefore, its clinical presentation may vary. Hepatobiliary involvement is rare, and typically asymptomatic; however, it can lead to cirrhosis, and may require liver transplantation. In this report, we present a rare case of a patient affected by sarcoidosis with hepatobiliary involvement. He presented to our hospital complaining of dyspnea triggered by moderate efforts and oppressive thoracic discomfort. Chest X-ray showed multiple bilateral nodular opacities and enlargement of both hilar regions, confirmed by a subsequent total-body computed tomography scan and positron emission tomography, which also revealed cardiac, splenic, and hepatic involvement. Liver function was studied via gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging, and magnetic resonance cholangiopancreatography (MRCP) was also performed. The diagnosis of sarcoidosis was finally achieved via liver biopsy, revealing non-necrotizing granulomas in the periportal space. The patient was treated with prednisone per os, with regression of all lesions at all levels. Although other cases of biliary sarcoidosis have been described, this report provides a complete image set of Gd-EOB-DTPA-enhanced magnetic resonance and MRCP images that is lacking in the English literature, and which may be useful for diagnosis.

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Case Report: Testicular Sarcoidosis: The Diagnostic Role of Contrast-Enhanced Ultrasound and Review of the Literature

Cited by 7 publications

References 45 publications

Testicular Sarcoidosis: An Underdiagnosed Manifestation That Poses Unique Challenges

Testicular Sarcoidosis: An Underdiagnosed Manifestation That Poses Unique Challenges

An Atypical Case of Extrapulmonary Sarcoidosis

Imaging of Biliary Involvement in Sarcoidosis: Computed Tomography, Magnetic Resonance Cholangiopancreatography, and Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid-Enhanced Magnetic Resonance Imaging Findings

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