Sarcoidosis mimicking metastatic breast cancer - a case report and literature review

ABSTRACT

This report contains a rare case of a patient diagnosed with breast cancer and sarcoidosis concomitantly. During breast cancer treatment, routine imaging tests were performed and showed hypermetabolic thoracic and abdominal lymph nodes suggestive of neoplasia that insinuated breast cancer progression. Diagnostic investigation was carried out and an excisional lymph node biopsy confirmed sarcoidosis diagnostic. Sarcoidosis is a systemic disease of unknown etiology, characterized by non-caseating granulomas in several organs, mainly in the lungs and lymphatic system. The association with cancer has been observed in several studies, gaining focus after the sarcoidosis-lymphoma syndrome. However, granulomatous and metastatic lymph node lesions are difficult to distinguish even with modern diagnostic methods. Thus, histological verification is the only method that can be used to accurately describe the nature of this disease. As granulomatosis and breast cancer have a high incidence worldwide, its differentiation becomes an important tool in the specialists diagnostic approach.

RESUMO

Este relato contém um caso raro de uma paciente diagnosticada com câncer de mama e sarcoidose concomitantemente. Durante o tratamento do câncer de mama, foram realizados exames de imagem de rotina e mostraram linfonodos torácicos e abdominais hipermetabólicos sugestivos de neoplasia que insinuavam progressão do câncer de mama. A investigação diagnóstica foi realizada e uma biópsia excisional de linfonodo confirmou o diagnóstico de sarcoidose. A sarcoidose é uma doença sistêmica de etiologia desconhecida, caracterizada por granulomas não caseosos em diversos órgãos, principalmente nos pulmões e sistema linfático. A associação com o câncer tem sido observada em diversos estudos, ganhando destaque após a síndrome sarcoidoselinfoma. No entanto, lesões linfonodais granulomatosas e metastáticas são difíceis de distinguir mesmo com métodos diagnósticos modernos. Assim, a verificação histológica é o único método que pode ser usado para descrever com precisão a natureza desta doença. Como a granulomatose e o câncer de mama têm alta incidência em todo o mundo, sua diferenciação torna-se uma importante ferramenta na abordagem diagnóstica do especialista.

Keywords:

Breast neoplasms - Sarcoidosis - Carcinoma, Ductal, Breast - Mastectomy - Neoadjuvant therapy - Radiotherapy, Adjuvant

Descritores:

Câncer de mama - Sarcoidose - Carcinoma de mama ductal - Mastectomia - Quimioterapia neoadjuvante - Radioterapia adjuvante

Publication History

Received: 30 May 2022

Accepted: 27 January 2023

Article published online:
02 March 2023

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