Title:Sarcoidosis and Sarcoid Reactions in Endometrial Cancer Cases Masquerading
Advanced Stage Malignancy
Volume: 18
Issue: 1
Author(s): Serkan Akis*, Canan Kabaca, Esra Keles, Handan Cetiner and Hatice Akay
Affiliation:
- Department of Gynecologic Oncology, University of Health Sciences, Zeynep Kamil Women and Children Disease
Training and Research Hospital, Istanbul, Turkey
Keywords:
Cancer staging, endometrial cancer, lymph node, sarcoidosis, sarcoid reaction, schaumann bodies.
Abstract:
Background: Sarcoidosis is usually diagnosed by ruling out other granulomatous inflammatory
diseases. Rarely, it may be suspected with a pathological examination after surgical intervention
for another disease. The sarcoid reaction is noninfectious granulomatous lymphadenitis,
which can occur at nodes draining a neoplasm. We demonstrated granulomatous lesions masquerading
metastasis by Positron Emission Tomography/Computed Tomography (PET/CT) in endometrial
cancer. We presented two cases of endometrial cancer with sarcoidosis and sarcoid-like reactions
because of their challenging clinical and radiological findings.
Cases: In case 1, there was diffuse granulomatous inflammation (no metastasis) in lymph nodes (n
= 92) and giant cells containing calcifications (Schaumann bodies). In case 2, PET/CT revealed hypermetabolism
with malignancy suspicion in the pelvic lymph nodes (maximum standardized uptake
value= 13) and pathological evaluation reported a 4.5 cm tumor within the uterine cavity without
any nodal metastasis.
Results: PET/CT has no role in the evaluation of differential diagnosis between granulomatous
lymphadenitis and metastatic disease.
Conclusion: Granulomatous lesions might mimic the metastasis of coexisting malignant diseases.
