Sarcoidosis mimicking lytic osseous metastases

Brandy-García, Anahy M.; Cabezas-Rodríguez, Iván; Caminal-Montero, Luis; Suárez-Cuervo, Carlos; Redondo-Buil, Pilar

doi:10.3949/ccjm.84a.16108

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…Although rarely observed, physicians should be aware that sarcoidosis can present itself as a pseudo tumoral condition such as miliary nodules, peritoneal involvement, and symptomatic osteolytic or osteoblastic lesions (102)(103)(104).…”

Section: When Should We Look For Neoplasia In Patients With Sarcoidosis?mentioning

confidence: 99%

Sarcoidosis and Cancer: A Complex Relationship

et al. 2020

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Sarcoidosis is a systemic disease of unknown etiology, characterized by the presence of non-caseating granulomas in various organs, mainly the lungs, and the lymphatic system. Since the individualization of sarcoidosis-lymphoma association by Brincker et al., the relationship between sarcoidosis or granulomatous syndromes and malignancies has been clarified through observational studies worldwide. Two recent meta-analyses showed an increased risk of neoplasia in sarcoidosis. The granulomatosis can also reveal malignancy, either solid or hematological, defining paraneoplastic sarcoidosis. Recent cancer immunotherapies, including immune checkpoint inhibitors (targeting PD-1, PD-L1, or CTLA-4) and BRAF or MEK inhibitors were also reported as possible inducers of sarcoidosis-like reactions. Sarcoidosis and neoplasia, especially lymphoma, can show overlapping presentations, thus making the diagnosis and treatment harder to deal with. There are currently no formal recommendations to guide the differential diagnosis workup between the evolution of lymphoma or a solid cancer and a granulomatous reaction associated with neoplasia. Thus, in atypical presentations (e.g., deeply impaired condition, compressive lymphadenopathy, atypical localization, unexplained worsening lymphadenopathy, or splenomegaly), and treatment-resistant disease, targeted biopsies on suspect localizations with histological examination could help the clinician to differentiate neoplasia from sarcoidosis. Pathological diagnosis could sometimes be challenging since very few tumor cells may be surrounded by massive granulomatous reaction. The sensitization of currently available diagnostic tools should improve the diagnostic accuracy, such as the use of more “cancer-specific” radioactive tracers coupled with Positron Emission Tomography scan.

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Section: When Should We Look For Neoplasia In Patients With Sarcoidosis?mentioning

confidence: 99%

Sarcoidosis and Cancer: A Complex Relationship

et al. 2020

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“…Sarcoidosis-related bone lesions resembling bone metastases on MRI may be the initial presentation. The presence of intralesional fat has been described as a feature that excludes malignancy [5,7,15]. Numerous areas of increased activity are seen positron emission tomography (PET) [17].…”

Section: Dıscussıonmentioning

confidence: 99%

“…Sarcoidosis can be a differential diagnostic challenge because of its nonspecific radiographic findings. Thus, a neoplastic cause such as primary osteoblastoma, metastasis, or multiple myeloma must always be excluded in differential diagnosis, together with other bone conditions such as osteomyelitis or bone cyst [7].…”

Section: Conclusıonmentioning

confidence: 99%

“…Bone involvement in sarcoidosis is uncommon that has been reported between 1% and 14% of the patients and the osseous lesions may emerge and induce resorption and loss of the bone. Typical osseous involvement is cystic osteitis of the phalangeal bones of hands and feet, but any part of the skeleton may be involved [5,7,8]. When the bone is affected by sarcoid lesion, it means the disease is commonly systemic and progressive [9,10].…”

Section: Introductionmentioning

confidence: 99%

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A Giant Enchondroma Mimicking Sarcoidosis: Report of Case and Review of the Literature

Atik¹,

lu²,

Şahin³

et al. 2019

ACO

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Sarcoidosis of the humerus is exceptionally rare and only a few cases have been reported. In this mini-review, a case of enchondroma in proximal humerus mimicking sarcoidosis and the features of bone involvement of sarcoidosis were reviewed. A 41-year-old female who was diagnosed with sarcoidosis in 2009 had used corticosteroids for 4 months. She had not any symptoms until 2014. She was admitted the clinic with a 2-month-history of erythema nodosum on her legs and right shoulder pain. Values of laboratory tests were all within normal limits except erythrocyte sedimentation rate and C-reactive protein levels. The mass in the proximal metaphyseal humerus has the characteristic as a medullary lesion which had calcifications in CT sections. MR images that the mass had low signal intensity on T1-weighted images and heterogeneous high signal intensity on T2-weighted images. It had irregular nodular contrast and the mass did not cause the expansion of the bone. Increased activity was observed on scintigraphy. We suspected the mass which was realized incidentally in a patient with sarcoidosis, could be bone sarcoidosis. As a result of our biopsy, it was enchondroma. Bone neoplasms should be kept in mind in issues like our case report.

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