Systemic sarcoidosis mimicking advanced testicular cancer

Woolf, Richard; Toms, Laurence; Mann, Bobby

doi:10.1258/jrsm.2009.090344

Cited by 4 publications

(8 citation statements)

References 13 publications

(23 reference statements)

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“…Additionally, in non-seminoma testicular cancers, serum AFP, -HCG, and LDH levels are elevated in only 50% of patients [40]. On the other hand, as in our case, elevated LDH [15,33,41] There have been only two large cohort studies on pediatric sarcoidosis; these included 46 and 41 cases, respectively [46,47]. Interestingly, no genital involvement was reported in either study.…”

Section: Case Reportcontrasting

confidence: 43%

Bilateral Painless Testicular Enlargement: An Unusual Presentation of Sarcoidosis and a Literature Review

Şimşek¹,

Şimşek²,

Dermiral³

et al. 2016

Int J Clin Endocrinol Metab

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Background: Sarcoidosis is a systemic infl ammatory disease characterized by non-caseating epitheloid granulomas; whereas it usually involves the lungs and lymph nodes, genitourinary involvement is extremely rare. For this reason, no consensus regarding the diagnostic and management options for testicular sarcoidosis has been reached. Objective: The aim of this case report was to describe an unusual clinical presentation of sarcoidosis. An 8-year-old boy presented with a 6-month history of painless scrotal enlargement and a 2-month history of photophobia, blurred vision, and pain in both eyes. Physical examination revealed tearing, conjunctival hyperemia, and nodular lesions in both eyes as well as bilateral, nontender, irregularly shaped, and very hard testes. Laboratory investigations revealed elevated serum angiotensin-converting enzyme levels, and 8 fl uoro-2-deoxyglucose positron emission tomography (FDG-PET) showed intense FDG accumulation in both testes. Testes biopsy showed non-caseating epitheloid granulomas, staining negative for acid-fast bacilli and fungi; tuberculosis culture was negative. A diagnosis of sarcoidosis was made. Conclusions: This is the fi rst reported case of testicular sarcoidosis in a Turkish child. Frozen section assessment is the most sensitive and reliable method for differentiating testicular masses. The diagnosis of testicular sarcoidosis should be made after excluding other infl ammatory diseases characterized by non-caseating epitheloid granulomas.

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Section: Case Reportcontrasting

confidence: 43%

Bilateral Painless Testicular Enlargement: An Unusual Presentation of Sarcoidosis and a Literature Review

Şimşek¹,

Şimşek²,

Dermiral³

et al. 2016

Int J Clin Endocrinol Metab

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“…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%

“…However, at times, sarcoidosis can affect other organs too, including the genitourinary (GU) system [ 5 ]. This is a rare manifestation, as it encompasses 0.2% of cases of sarcoidosis.…”

Section: Introductionmentioning

confidence: 99%

“…As of 2019, only 68 cases of GU sarcoidosis had been reported in the literature [ 6 , 7 ]. In these cases, the patients had a testicular mass, which was biopsied and verified to be sarcoidosis [ 5 ]. However, there is also an association between the overall incidence of sarcoidosis and testicular cancer, with the incidence of sarcoidosis being 100-fold higher in patients with known testicular cancer [ 6 ].…”

Section: Introductionmentioning

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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“…Of note, elevated LDH levels have been found in some cases of sarcoidosis and therefore are also not considered reliable [13,14]. Elevation of other tumour markers such as alpha-foetoprotein and beta-HCG has been less frequently reported [15].…”

Section: Primary Urologic Sarcoidosismentioning

confidence: 99%

Urologic and Urinary Manifestations of Sarcoidosis

Vanderhulst¹

2017

Med Surg Urol

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Sarcoidosis is a chronic granulomatous disease than most commonly affects the lungs, but concomitant -or exceptionally isolated-extrapulmonary involvement is frequent. Urologic symptoms may occur in a patient known with sarcoidosis or may reveal the disease.The present review illustrates the protean nature of the disease, which can manifest with any of the common urologic symptoms and can be mistaken for other conditions such as infection and cancer. An insight into diagnostic and therapeutic management is also proposed.We hope to increase awareness about urologic manifestations of sarcoidosis in order to help the clinicians avoiding misdiagnosis, which could expose the patients to unnecessary medications or surgical procedures, progressive disease, recurrence and long-term sequelae.

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Systemic sarcoidosis mimicking advanced testicular cancer

Cited by 4 publications

References 13 publications

Bilateral Painless Testicular Enlargement: An Unusual Presentation of Sarcoidosis and a Literature Review

Bilateral Painless Testicular Enlargement: An Unusual Presentation of Sarcoidosis and a Literature Review

Testicular Sarcoidosis: An Underdiagnosed Manifestation That Poses Unique Challenges

Urologic and Urinary Manifestations of Sarcoidosis

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