Muscular Sarcoidosis Detected by F-18 FDG PET/CT in a Hypercalcemic Patient

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology that involves many organs, occasionally mimicking malignancy. We herein report a 50-yr-old woman of muscular sarcoidosis of chronic myopathic type, manifested by hypercalcemia and muscle wasting. Besides insignificant hilar lymphadenopathy, her sarcoidosis was confined to generalized atrophic muscles and therefore, F-18 FDG PET/CT alone among conventional imaging studies provided diagnostic clues for the non-parathyroid-related hypercalcemia. On follow-up PET/CT during low-dose steroid treatment, FDG uptake in the muscles disappeared whereas that in the hilar lymph nodes remained. PET/CT may be useful in the evaluation of unexpected disease extent and monitoring treatment response in suspected or known sarcoidosis patients.

Sarcoidosis misdiagnosed as malignant tumors: a case report

“…Moreover, 18 F-FDG PET has been proven to be a very useful imaging technique in diagnosis, disease activity assessment, monitoring treatment response, and risk assessment in patients with sarcoidosis [ 10 ]. In suspected or known sarcoidosis patients, PET-CT may be useful in the evaluation of disease extent and monitoring treatment response [ 11 ]. In atypical, complex, and multisystem sarcoidosis, PET-CT plays an important role for the evaluation of the localization and effect of treatment [ 12 ].…”

Muscular sarcoidosis in the eyes of 18F‐FDG PET/CT

“…Three clinical subtypes of muscular sarcoidosis are known: chronic myopathy, acute myositis, and nodular myositis 9 . Chronic myopathy is the most common form, followed by proximal symmetric muscle weakness/atrophy with normal or elevated serum levels of muscle enzymes 8 . This pattern is unfortunately related with thoracic involvement.…”

“…Radiologic procedures are also unable to discriminate active disease. It is suggested that hybrid imaging methods may be helpful in evaluation of granulomatous diseases 8,21 …”

A Rare Case of Sarcoidosis Presenting as Diffuse Contracturing Granulomatous Myositis on Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

“…The potential use of FDG PET/CT in diagnostic evaluation and monitoring treatment response in granulomatous myositis secondary to sarcoidosis has already been reported in few case studies in the past. [ 9 10 11 ] PET/CT can also help in guiding biopsy from the most accessible site which is showing high degree of FDG uptake. Diffuse FDG in the skeletal muscles is, however, not a specific finding for granulomatous myositis; it can also be seen in the patients with dermatomyositis/polymyositis, thyrotoxicosis, and in patients where PET/CT scans was done in fed state or hyperinsulinemia.…”