Extrapulmonary sarcoidosis: rapid spontaneous remission of marked splenomegaly

Splenomegaly, when present as a manifestation of sarcoidosis, may cause pressure symptoms and hypersplenism. Literature reports of giant splenomegaly are few in number and describe the use of aggressive intervention with systemic steroids and splenectomy. However, the natural history of splenic sarcoidosis is not well-defined, particularly the potential for spontaneous remission as seen in pulmonary sarcoidosis. In the case described here, a spontaneous remission of giant splenomegaly from sarcoidosis was observed. Careful follow-up appears to be appropriate management for at least some of these patients.