Reactions 1680, p45 - 2 Dec 2017 Sarcoidosis: 3 case reports In a case series, three adult women [exact ages at the time of reactions onset not stated] developed mediastinal sarcoidosis following treatment with tamoxifen or carboplatin or bleomycin, etoposide, cisplatin, ifosfamide and carboplatin [routes, dosages and time to reactions not stated]. Case 1: In July 2009, the woman was diagnosed with metastatic infiltrating lobular carcinoma at the age of 48 years. Later, she was started on hormonal therapy with tamoxifen for 12 months. Three years later, chest CT scan revealed multiple lymph nodes in the mediastinum, while the positron emission tomogram (PET) scan showed positive uptake value. Three months later, the second PET scan revealed stable lymph node growth. Mediastinal biopsy of the lymph nodes showed non- caseating giant cells granulomas, which was consistent with sarcoidosis. She was treated with unspecified corticosteroids and showed favourable results with mediastinal lymph node recurrence. Case 2: In March 2009, the woman was diagnosed with epidermoid carcinoma of the cervix with multiple abdominal lymph nodes at the age of 47 years. She was started on chemotherapy with 2 cycles of bleomycin, cisplatin and etoposide. Subsequently, she received 2 cycles of carboplatin, etoposide and ifosfamide. She was taking insulin for underlying diabetes. In December 2012, three years after the completion of the treatment, she experienced progressive dyspnoea. The PET scan revealed mediastinal and hilar nodes. The malignant recurrence was suspected, and mediastinoscopy was performed. Eventually, a lymph node biopsy revealed lymph node sarcoidosis, without malignancy. She did not receive treatment for sarcoidosis and was in stable condition. Case 3: The woman was diagnosed with stomach carcinoma at the age of 59 years. In February 2009, she underwent gastrectomy. Later, she developed stage 1 tubular adenocarcinoma of the stomach. She received 4 cycles of carboplatin over the period of 13 weeks until June 2009 and showed positive result. Thirty months after the gastrectomy, she presented with an unexplained chronic cough. In August 2013, the PET scan showed positive uptake value. A chest CT scan revealed multiple lymph nodes in the right paratracheal area and Barety’s space. The most likely diagnosis of lymph node metastasis was considered. However, histological analysis of the tissue sample obtained with mediastinoscopy confirmed the diagnosis of sarcoidosis. She was treated with unspecified corticosteroids, which showed favourable results with mediastinal lymph node recurrence. Author comment: "The relationship between anti- neoplastic treatment and sarcoidosis is controversial. Some authors believe that it is linked to the type of malignancy, genetic predisposition, and anti-neoplastic therapy that can trigger onset of sarcoidosis." "The aim of this paper is to raise awareness about the development of this disease after cancer treatment to avoid misdiagnosis with FDG-PET/CT studies". El Hammoumi M, et al. Mediastinal Sarcoidosis Mimicking Lymph Malignancy Recurrence After Anti-neoplastic Therapy. Archivos de Bronconeumologia 51: e33-e35, No. 7, Jul 2015. Available from: URL: http://doi.org/10.1016/ j.arbr.2015.02.021 - Morocco 803285579 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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