Atypical extrapulmonary localization of sarcoidosis – a clinical case
General Medicine, 2024, 26(1), 37-40.
D. Pazardzhikliev1, 2, I. Doykov1, 2, M. Kraeva2, 3, M. Doykov4, 5, S. Konsulov1, 2, D. Milkov1,2
1 Clinic of Otorhinolaryngology, University Hospital Kaspela – Plovdiv
2 Department of Otorhinolaryngology, Medical University – Plovdiv
3 Clinic of Otorhinolaryngology. Sveti Cosma and Damian Hospital – Plovdiv
4 Clinic of Urology, University Hospital Kaspela – Plovdiv
5 Department of Urology and General Medicine, Medical University – Plovdiv
Abstract. Sarcoidosis is a systemic inflammatory disease, characterized by the formation of non-ca-seous inflammatory granulomas in affected organs. Even in the 21st century, the etiology of the disease remains uncertain, as the symptoms are diverse. The disease most often affects the lungs, but extrapulmonary localizations have also been observed, e.g. in the paranasal sinuses and upper respiratory tract, eyes, musculoskeletal system, skin and others. The manifestation of the disease in the scar of a prior surgical intervention is extremely rare. Case presentation: We present the clinical case of a patient who developed sarcoidosis in a postoperative cicatrix from a surgery performed before 27 years. She complained only of a growing tumor underneath the scar. Despite computed tomography signs for enlarged mediastinal lymph nodes, the patient did not have any systemic complaints. The tumor was excised and the histological result indicated the presence of epitheloid-cell granulomas, without necrosis, which were indicative of the diagnosis of sarcoidosis. Conclusion: The development of the typical granulomas of sarcoidosis in cicatricial tissue is extremely rare with only a few similar cases described in literature. This can be the first manifestation of a severe and systemic disease, without any other symptoms. The surgical significance of sarcoidosis is great, as a late diagnosis can lead to disease progression with involvement of many structures and tissues and severe organ damage.
Key words: sarcoidosis, scar sarcoidosis, tumor formation, mediastinal lymphadenopathy
Address for correspondence: Denis Milkov, e-mail: denismilkov@gmail.com