Darier-Roussy Sarcoidosis Mimicking Metastatic Breast Cancer

Abstract

Subcutaneous sarcoidosis (also known as ‘Darier-Roussy sarcoid’) is a cutaneous condition characterized by numerous deep-seated nodules on the trunk and extremities. Coexistence of sarcoidosis and breast cancer are reported in the literature, but there will always be a chance of misdiagnosis. It is very crucial to obtain a tissue diagnosis of suspicious metastatic lesions. We report a case of breast cancer presenting with a subcutaneous sarcoid lesion masquerading as a metastatic lesion. A 50-year-old female patient, who had had cancer of the left breast, was on hormone therapy 2 years after treatment with surgery, radiotherapy and chemotherapy. The patient presented with a sudden onset of a forehead subcutaneous swelling mimicking metastasis which on excision biopsy was proved to be sarcoidosis. In India, sarcoidosis is reported rarely. We have to keep in mind that there is a chance of the metastatic lesions being of sarcoidosis origin or another granulomatous disease. To avoid misdiagnosis, it is better to obtain a tissue diagnosis.

Sarcoidosis mimicking metastatic papillary thyroid cancer

“…Management of co-existing PTC and SA can be challenging because both of diseases can affect the same organs and the incidences are very similar [4] . An interesting finding of our case is that both diseases were not known by the physician until the time of presentation while in other cases patients are known to have at least one of the disease before cosultation [1] , [2] , [5] . and this make more cofusion for diagnostic workup and need special attension.…”

“…Sarcoidosis (SA) (flesh-like process) is a multisystemic, idiopathic disease which is characterized by non-caseating epithelioid granulomas mainly involving the lungs (90%), lymph nodes, eyes, and skin [1] . It has a highly variable clinical course [2] .…”

Breast Cancer and Sarcoidosis: Case Series and Review of the Literature

“…Our review of the literature identified 104 patients diagnosed with breast cancer and sarcoidosis (n = 66) or sarcoid-like reaction (n = 38) [1,8,13,14,18,19,20,21,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53]. …”

Primary Sarcoid of the Breast with Incidental Malignancy

“…[ 6 ] Many authors theorize that patients with sarcoidosis are predisposed to malignancy, although others believe that malignancy may lead to sarcodosis. [ 7 ] In very rare cases such as ours, both pathologies may coexist in the breast.…”