Beyond the Usual Suspects: Primary Premaxilla Sarcoidosis

Area of Science:

• Maxillofacial Surgery
• Pathology
• Radiology

Background:

• Sarcoidosis is a systemic granulomatous disease with variable organ involvement.
• Extrapulmonary sarcoidosis, particularly in the premaxilla, is exceptionally rare.
• Diagnosis can be challenging due to non-specific symptoms and rarity.

Observation:

• A 62-year-old male presented with a three-year history of painless cheek swelling.
• Fine Needle Aspiration Cytology (FNAC) provided no definitive diagnosis.
• Contrast-enhanced CT scan identified a premaxillary soft tissue lesion.

Findings:

• Histopathological analysis of the excised lesion revealed non-caseating granulomas with asteroid bodies, confirming sarcoidosis.
• The patient had no evidence of systemic sarcoidosis.
• Complete surgical excision of the premaxillary lesion was achieved.

Implications:

• This case underscores the importance of considering rare diagnoses like premaxillary sarcoidosis in maxillofacial swelling.
• A multidisciplinary approach combining clinical, imaging, and histopathological evaluation is crucial for accurate diagnosis.
• Increased awareness of such presentations can improve diagnostic accuracy and patient management for extrapulmonary sarcoidosis.