Association between sarcoidosis and testicular carcinoma: a diagnostic pitfall

Sarcoidosis is a multisystemic, non-caseous, benign granulomatous disease of unknown etiology that is sometimes associated with testicular cancer. This association, which does not appear to be accidental, can give rise to diagnostic problems because adenopathies or parenchymatous pulmonary nodules related to sarcoidosis can lead to the presumption of metastatic testicular cancer. The objective of this article was to assess the clinical, histological, and radiological characteristics of the association between sarcoidosis and testicular cancer to help clinicians avoid potentially fatal diagnostic traps and management errors.

Literature review.

A total of 64 cases of sarcoidosis concomitant with testicular cancer were described in the literature. In more than 50% of the cases (35/64), testicular cancer was diagnosed before sarcoidosis or sarcoid-like reaction. Cancer was diagnosed concomitantly in 31% of cases (20/64). Every anatomopathological type of testicular tumor was described in association with sarcoidosis. Seminoma was the most frequent tumor, occuring in 62% (40/64) of patients. In 80% of the cases (51/64) sarcoidosis regressed spontaneously.

Testis cancer may be accompanied by a sarcoid-like reaction or can be associated with real sarcoidosis. The association of testicular cancer with sarcoidosis did not change the therapeutic management of either of these two pathologies. The presence of sarcoidosis does not change the cancer prognosis. Sarcoidosis is a benign disease that resolved favorably and spontaneously in 80% of the cases.