Concurrent Diagnoses of Cutaneous Sarcoidosis and Recurrent Metastatic Breast Cancer: More than a Coincidental Occurrence?

Abstract

Sarcoidosis is a rare, chronic, multisystem disease of unknown aetiology, characterised by non-caseating epithelioid cell granulomas. Its association with internal malignancy, in particular haematological cancers has been strongly documented in the literature, while its link with solid organ malignancies is less extensively reported. We present an atypical case of cutaneous sarcoidosis occurring in association with breast cancer recurrence in a 49-year-old female. Physician recognition of this link between sarcoidosis and internal malignancy is vital because many cases of sarcoidosis in association with neoplasia present initially, or even exclusively, with cutaneous sarcoidal lesions that may precede the development of cancer by several years, or as in our case, present as a cutaneous marker of concomitant underlying malignancy. Our case highlights the importance of age-appropriate cancer screening in additional to a routine work-up for systemic sarcoidosis in a patient with cutaneous sarcoidosis.

Sarcoidosis Presenting as Late Seroma Mimicking Breast Implant–Associated Anaplastic Large Cell Lymphoma

“…14 It is recommended that once sarcoidosis is diagnosed, routine cancer screening and close follow-up is done, because synchronic development or exacerbation of the tumor has been described in multiple reports. 17,40,41 Treatment and Breast Reconstruction After Sarcoidosis in Patients With Breast Implants Our experience sustains the concept that implant removal results in disease improvement and clinical remission of sarcoidosis, providing an interesting indication of the etiological role of breast implants in sarcoidosis. Therefore, surgery is recommended to all patients with sarcoidosis of the breast that have silicone implants.…”

“…It is recommended that once sarcoidosis is diagnosed, routine cancer screening and close follow-up is done, because synchronic development or exacerbation of the tumor has been described in multiple reports 17,40,41 …”

“…7,11 Furthermore, it has been recently mentioned that there is an increased risk of sarcoidosis in some solid tumors including breast cancer. 12,13 Apart from cancer relapse, sarcoidosis must be considered in the differential diagnosis of patients with a history of malignancy who develop lymphadenopathy in PET-CT. 13,39 As Deen et al 40 explain, dysregulation of the immune system mediated by either the breast cancer or sarcoidosis leads to the granulomatous inflammation of sarcoidosis or neoplasm, respectively. In most cases, sarcoidosis was diagnosed before the detection of an associated neoplasm, and a cross-reaction or antigenic mimicry with tumor antigens has been postulated.…”