Sarcoidosis mimicking metastatic gynaecological malignancies: a diagnostic and therapeutic challenge?

Rev Esp Med Nucl Imagen Mol. 2013 Sep-Oct;32(5):314-7. doi: 10.1016/j.remn.2012.11.001. Epub 2012 Dec 25.

Abstract

Several case reports describing the coexistence of sarcoidosis and malignancy have been published. Therefore, sarcoidosis should always be considered as a differential diagnosis when a cancer patient develops lymphadenopathy. Positron-emission tomography (PET) 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) combined with computed tomography (CT) is widely used for cancer staging and surveillance because it permits localization of metabolically active malignant tissue. PET/CT or CT findings in patients with suspected cancer recurrence can be used to guide early and aggressive therapy. However, benign hypermetabolic lymphadenopathy can mimic malignant lymphadenopathy, both on a conventional CT scan and on PET/CT. Thus, it is important to obtain a histological diagnosis before initiating antineoplastic therapy based on imaging findings. Four cases of patients affected by gynaecological malignancies and coexisting sarcoidosis are reported in this study. Furthermore, the clinical relevance of making a differential diagnosis between gynaecological cancer recurrence and granulomatous disorder is given specific mention.

Keywords: Cáncer ginecológico; FDG-PET/CT; Gynaecological malignancies; PET/CT false positive; PET/CT falso positivo; Sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / therapy
  • Adenocarcinoma, Clear Cell / complications
  • Adenocarcinoma, Clear Cell / diagnostic imaging
  • Adenocarcinoma, Clear Cell / secondary*
  • Adenocarcinoma, Clear Cell / therapy
  • Adult
  • Carcinoma, Adenosquamous / complications
  • Carcinoma, Adenosquamous / diagnostic imaging*
  • Carcinoma, Adenosquamous / secondary*
  • Carcinoma, Adenosquamous / therapy
  • Carcinoma, Endometrioid / complications
  • Carcinoma, Endometrioid / diagnostic imaging
  • Carcinoma, Endometrioid / secondary*
  • Carcinoma, Endometrioid / therapy
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Endometrial Neoplasms / complications
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / therapy
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Granuloma, Giant Cell / diagnostic imaging
  • Granuloma, Giant Cell / etiology
  • Humans
  • Infant
  • Lung Diseases / complications
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / drug therapy
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary*
  • Lymph Nodes / diagnostic imaging
  • Middle Aged
  • Multimodal Imaging*
  • Neoplasm Staging
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Sarcoidosis / complications
  • Sarcoidosis / diagnostic imaging*
  • Sarcoidosis / drug therapy
  • Tomography, X-Ray Computed*
  • Uterine Cervical Neoplasms / complications
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18