Sarcoidosis mimicking recurrent endometrial cancer

Abstract

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.