Primary Sarcoidosis of the Temporal Bone a Clinical Pathologic Correlation

Area of Science:

• Otolaryngology
• Oncology
• Pathology

Background:

• Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
• Osseous involvement in sarcoidosis is uncommon and often secondary to other manifestations.
• Lytic bone lesions in the temporal bone typically raise concerns for malignancy or infection.

Purpose of the Study:

• To report a rare case of sarcoidosis presenting as an isolated lytic bone lesion in the temporal bone.
• To emphasize the importance of considering sarcoidosis in the differential diagnosis of temporal bone lesions.

Main Methods:

• A 64-year-old woman with aural fullness, tinnitus, and otalgia underwent CT and MRI.
• Imaging revealed an osseodestructive, lytic bone lesion in the temporal bone.
• Excisional biopsy confirmed granulomatous infiltration consistent with osseous sarcoidosis.

Main Results:

• Imaging findings suggested a lytic bone lesion requiring biopsy for diagnosis.
• Excisional biopsy confirmed osseous sarcoidosis with minimal patient morbidity.
• Surgical removal of the mass led to complete resolution of the patient's symptoms.

Conclusions:

• Osseous sarcoidosis is a rare but possible cause of lytic bone lesions in the temporal bone.
• Sarcoidosis should be included in the differential diagnosis for such lesions.
• Prompt diagnosis and surgical intervention can lead to favorable outcomes.