Co-existence of metastatic uterine sarcoma and orbital sarcoidosis: A case report and literature review
Main Article Content
Keywords
Sarcoidosis, Sarcoma, Metastasis
Abstract
A 77-year old lady with previously treated endometrial sarcoma presented with progressive left upper lid mechanical ptosis secondary to superior orbital mass. An orbital biopsy confirmed the diagnosis of orbital sarcoidosis. Further systemic work up revealed suspicious pulmonary nodules which were found to be endometrial sarcoma metastases rather than systemic sarcoidosis on image guided biopsy. She was treated with 20 months of chemotherapy for metastatic sarcoma. The ptosis completely resolved, however, pulmonary metastases progressed despite chemotherapy. The co- existence of malignancy with sarcoidosis should be considered in all cases of new onset sarcoidosis. Biopsy of suspicious lesions, close observation and multidisciplinary team management is advocated for these patients.
References
2. Tana C, Giamberardino MA, Di Gioacchino M, Mezzetti A, Schiavone C. Immunopathogenesis of sarcoidosis and risk of malignancy: a lost truth? Int J Immunopathol Pharmacol. 2013 Apr- Jun; 26(2):305-13.
3. Brincker H. Sarcoid reactions and sarcoidosis in Hodgkin’s disease and other malignant lymphomata. Br J Cancer. 1972 Apr; 26 (2):120-123.
4. Reich JM. Neoplasia in the etiology of sarcoidosis. Eur J Intern Med. 2006 Mar; 17(2):81-7.
5. Cohen PR, Kurzrock R. Sarcoidosis and malignancy. Clin Dermatol. 2007 May- Jun; 25(3):326-33.
6. Espejo AP, Ramdial JL, Wilky BA, Kerr DA, Trent JC. A nonrandom association of sarcoidosis in patients with gastrointestinal stromal tumor and other sarcomas. Rare Tumors. 2018 Jul 18;10:1-7
7. Newman LS, Rose CS, Maier LA. Sarcoidosis. N Engl J Med. 1997 Apr 24; 336(17):1224-34.
8. Bradley D, Baughman RP, Raymond L, Kaufman AH. Ocular manifestations of sarcoidosis. Semin Respir Crit Care Med. 2002 Dec; 23(6):543-8.
9. Mavrikakis I, Rootman J. Diverse clinical presentations of orbital sarcoid. Am J Ophthalmol. 2007 Nov; 144(5):769-75.
10. Prabhakaran VC, Saeed P, Esmaeli B, et al. Orbital and adnexal sarcoidosis. Arch Ophthalmol. 2007 Dec; 125(12):1657-62.
11. Rothova A, Alberts C, Glasius E, Kijlstra A, Buitenhuis HJ, Breebaart AC. Risk factors for ocular sarcoidosis. Doc Ophthalmol. 1989 Aug; 72(3-4):287-96.
12. Obenauf CD, Shaw HE, Sydnor CF, Klintworth GK. Sarcoidosis and its ophthalmic manifestations. Am J Ophthalmol. 1978 Nov; 86(5):648-55.
13. Collison JM, Miller NR, Green WR. Involvement of orbital tissues by sarcoid. Am J Ophthalmol. 1986 Sep; 102(3): 302-7
14. Sah BP, Sharma B, Iannuzzi MC. Isolated extraocular orbital mass: A rare presentation of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2016 Oct 7;33(3): 302-4
15. Bonifazi M, Bravi F, Gasparini S, et al. Sarcoidosis and cancer risk: systematic review and meta-analysis of observational studies. Chest. 2015 Mar; 147(3):778-91.
16. Askling J, Grunewald J, Eklund A, Hillerdal G, Ekbom A. Increased risk of cancer following sarcoidosis. Am J Respir Crit Care Med. 1999 Nov; 160 (5 Pt 1):1668-72.
17. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1990 Aug; 160(2):736‐55.
18. Pavic M, Debourdeau P, Vacelet V, Rousset H. Place de la pathologie granulomateuse au cours des cancers [Sarcoidosis and sarcoid reactions in cancer]. Rev Med Interne. 2008 Jan; 29(1):39-45. French
19. Birnbaum AD, Oh FS, Chakrabarti A, Tessler HH, Goldstein DA. Clinical features and diagnostic evaluation of biopsy-proven ocular sarcoidosis. Arch Ophthalmol. 2011 Apr;129(4):409-13.
20. Ji J, Shu X, Li X, Sundquist K, Sundquist J, Hemminki K. Cancer risk in hospitalized sarcoidosis patients: a follow-up study in Sweden. Ann Oncol. 2009 Jun; 20(6):1121-6.
21. Shu X, Ji J, Sundquist K, Sundquist J, Hemminki K. Survival in cancer patients with previous hospitalization for sarcoidosis: a Swedish population-based cohort study during 1964-2006. Ann Oncol. 2011 Jun; 22(6):1427-34.