Sarcoidosis of female reproductive organs in a postmenopausal woman: a case report and review of the literature: is there a potential for hormone therapy?

Menopause. 2015 May;22(5):549-53. doi: 10.1097/GME.0000000000000347.

Abstract

Objective: Sarcoidosis is a multisystem inflammatory disorder of unknown cause that affects multiple organs. To date, only isolated cases of extrapulmonary sarcoidosis of the female reproductive tract, which rarely affects postmenopausal women, have been reported.

Methods: We describe the case of a postmenopausal woman with sarcoidosis of multiple structures of the genital tract accompanied by pulmonary involvement. A review of the literature was performed to examine the role of sex hormones in the pathogenesis of sarcoidosis.

Results: We describe the case of a 60-year-old white, nulliparous, nulligravid postmenopausal woman with sarcoidosis of the cervix, uterus, mesosalpinx, and right ovary, accompanied by pulmonary involvement. The diagnosis was based on the identification of noncaseating granulomas in reproductive tract organs. Although imaging methods (high-resolution CT and chest x-ray) and pulmonary function tests did not reveal any abnormality, lung involvement was confirmed histologically by transbronchial biopsy. Treatment with steroids was successful and led to normalization of serum biomarker (serum angiotensin-converting enzyme, soluble interleukin-2 receptor, and neopterin) levels.

Conclusions: This particular case and a brief literature review of female genital tract sarcoidosis in postmenopausal women suggest the role of sex hormones in the pathogenesis of sarcoidosis. Hormone therapy may be a prospective therapeutic alternative to corticosteroids in postmenopausal women.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Biomarkers / blood
  • Female
  • Genital Diseases, Female / diagnosis*
  • Genital Diseases, Female / drug therapy
  • Granuloma / pathology
  • Humans
  • Lung Diseases / diagnosis
  • Middle Aged
  • Ovarian Diseases / diagnosis
  • Postmenopause*
  • Radiography, Thoracic
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / drug therapy
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Uterine Cervical Diseases / diagnosis
  • Uterine Diseases / diagnosis

Substances

  • Adrenal Cortex Hormones
  • Biomarkers