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Sarcoidosis mimicking recurrent endometrial cancer
John L Powell1, Erica S Cunill, Walter H Gajewski
1Department of Obstetrics, New Hanover Regional Medical Center, Coastal Area Health Education Center, 2131 South 17th Street, Wilmington, NC 28402-9025, USA. john.powell@coastalahec.org
Background:
Sarcoidosis is a multisystem disease and can be confused with benign or malignant tumors. In patients with recurrent gynecologic cancer, liver and intrathoracic lesions should undergo a biopsy to rule in metastatic malignancy, as clinical findings and CAT scan results may represent other disease processes.
Case:
A 67 year old woman had a total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and periaortic lymphadenectomy, and peritoneal cytology in 2001 for Stage I B grade 1 adenocarcinoma of the endometrium. She developed a vaginal recurrence in 2005. A CT scan of lungs, abdomen, and pelvis revealed extensive mediastinal adenopathy and multiple space occupying hepatic lesions worrisome for metastatic disease. A needle biopsy of the largest liver lesion revealed sarcoidosis.
Conclusion:
Sarcoid lesions may mimic metastatic disease in patients with malignancy, potentially leading to delayed and/or inappropriate therapy.
