Interesting case of ovarian sarcoidosis: The value of multi disciplinary team working

Wuntakal, Rekha; Bharathan, Rasiah; Rockall, Andrea; Jeyarajah, Arjun

doi:10.1186/1477-7819-5-38

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…It is usually detected while investigating the cause of abnormal uterine bleeding in patients with a previous history of sarcoidosis at other anatomic sites (52). Ovarian sarcoidosis is extremely rare and known to mimic ovarian malignancy with soft tissue nodules (51). There is no specific radiological finding in the literature to describe ovarian sarcoidosis (51).…”

Section: Genital Tractmentioning

confidence: 99%

See 1 more Smart Citation

Abdominal sarcoidosis: cross-sectional imaging findings

Gezer¹,

Başara²,

Altay³

et al. 2015

Diagn Interv Radiol

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Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%-70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis.

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Section: Genital Tractmentioning

confidence: 99%

“…Ovarian sarcoidosis is extremely rare and known to mimic ovarian malignancy with soft tissue nodules (51). There is no specific radiological finding in the literature to describe ovarian sarcoidosis (51).…”

Section: Genital Tractmentioning

confidence: 99%

Abdominal sarcoidosis: cross-sectional imaging findings

Gezer¹,

Başara²,

Altay³

et al. 2015

Diagn Interv Radiol

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“…1 A sarcoidose ovárica é uma condição rara, que pode mimetizar neoplasia havendo poucos casos descritos. 4,9 No caso apresentado, após o tratamento com anti-tuberculosos, a doente mantinha sintomas constitucionais e tosse. Imagiologicamente, a nível pulmonar persistiam adenopatias mediastínicas e infiltrado reticular/nodular e analiticamente apresentava ECA elevada, motivo pelo qual se realizou bióp-sia transtorácica que foi compatível com sarcoidose pulmonar.…”

Section: Discussionunclassified

Sarcoidose ovárica e pulmonar – um diagnóstico a considerar

2017

Gal. Clin.

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ResumoA sarcoidose é uma doença granulomatosa sistémica de etiologia desconhecida. A tuberculose pode preceder, coexistir com a sarcoidose ou, menos frequentemente, trata-se de uma doença oportunista nos doentes com sarcoidose sob corticoterapia. Os autores apresentam o caso de uma doente de 60 anos que iniciou queixas de tosse seca, febre e sudorese noturna. Posteriormente aparecimento de massa pélvica, tendo sido colocada a hipótese de neoplasia do ovário e submetida a histerectomia e anexectomia bilateral. Exame histológico revelou estruturas granulomatosas circunscritas, constituídos por histiócitos, sem evidência de necrose caseosa. Exame cultural do líquido ascítico isolamento de Mycobacterium tuberculosis. TC de tórax revelou múltiplas adenomegalias mediastínicas e espessamento difuso do interstício, com um padrão misto reticular/nodular. Cumpriu 9 meses de anti-tuberculosos. Analiticamente elevação da enzima de conversão da angiotensina. Efetuada biópsia pulmonar transtorácica, cuja histologia revelou septos interalveolares espessados por fibrose e infiltrado de macrófagos epitelióides, com granulomas não caseosos, compatíveis com o diagnóstico de sarcoidose. Palavras-chave: sarcoidose pulmonar; sarcoidose ovárica; tuberculose. AbstractSarcoidosis is a systemic granulomatous disease of unknown etiology. Tuberculosis may precede, coexist with sarcoidosis or, less frequently, is an opportunistic disease in patients with sarcoidosis under corticosteroid therapy. We present a 60-year-old woman who complained of dry cough, fever and night sweats. Subsequently, a pelvic mass suggestive of ovarian neoplasia appeared, and hysterectomy and bilateral adnexectomy were performed. Histological examination revealed circumscribed granulomatous structures, constituted by histiocytes, with no evidence of caseous necrosis. Mycobacterium tuberculosis grew in ascitic fluid culture. Chest CT revealed multiple mediastinal adenomegalies and diffuse interstitial thickening, with a mixed reticular/nodular pattern. She completed 9 months of tuberculosis therapy. Blood test showed elevation of angiotensin converting enzyme. A transthoracic pulmonary biopsy was performed, with histology revealing thickening by fibrosis of interalveolar septa and epithelioid macrophages infiltration with non-caseous granulomas compatible with sarcoidosis.

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“…Based on the literature review, it seems that the uterus is the most commonly involved organ of the female genital tract [7, 8]. In 1933, Garland and Thompson first described an autopsy finding of sarcoidosis involving the uterus in a 28-year-old female.…”

Section: Discussionmentioning

confidence: 99%

“…Like uterine sarcoidosis, most of the reported cases occurred in the reproductive age group [7, 20–25], although a few cases of ovarian sarcoidosis in postmenopausal women have also been reported [26–28]. Symptoms can be nonspecific, such as fever, malaise, and abdominal pain [29], or they can present with clinical features concerning for ovarian tumors, such as ovarian enlargement, weight loss, obstructive uropathy, intraperitoneal mass, and ascites associated with thickening of the omentum and peritoneal nodular deposits [7, 21–24, 28]. In these cases, diagnosis was made based on histopathological findings and ruling out other causes of granulomatous inflammation.…”

Section: Discussionmentioning

confidence: 99%

Uterine Sarcoidosis: A Rare Extrapulmonary Site of Sarcoidosis

Marak

Alappan

Chopra

et al. 2013

Case Reports in Rheumatology

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Sarcoidosis is a multisystem disease which is most commonly manifested in the pulmonary system. However, extrapulmonary manifestations have also been frequently reported. Isolated occurrence of sarcoidosis in the genital system is rare and poses a diagnostic and therapeutic dilemma. Uterine sarcoidosis can present with cervical erosions, endometrial polypoid lesions, and recurrent serometra. In majority of cases, it is diagnosed by endometrial curettage, but it has also been detected by examination of hysterectomy, polypectomy, and autopsy specimens. Nonnecrotizing granulomas are the characteristic pathologic finding of sarcoidosis. However, many infectious and noninfectious etiologies including certain neoplasms can produce similar granulomatous reactions in the female genital tract. These conditions affect the female genital tract more commonly than sarcoidosis, and therefore it is important to rule out these conditions first before making a diagnosis of sarcoidosis. Treatment of sarcoidosis is different from treating these other conditions and the most commonly used systemic or local corticosteroids can be hazardous if the underlying cause is infection. In this case report, the clinical presentation, histopathology, clinical course, and treatment of a patient with isolated uterine sarcoidosis are described, and a brief literature review of sarcoidosis of the female genital tract is provided.

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Interesting case of ovarian sarcoidosis: The value of multi disciplinary team working

Abstract: The case shows the importance of FNAC and biopsy in case or ovarian masses and multi disciplinary team approach to management.

Cited by 12 publications

References 6 publications

Abdominal sarcoidosis: cross-sectional imaging findings

Abdominal sarcoidosis: cross-sectional imaging findings

Sarcoidose ovárica e pulmonar – um diagnóstico a considerar

Uterine Sarcoidosis: A Rare Extrapulmonary Site of Sarcoidosis

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