Cancer Res Treat.  2013 Dec;45(4):354-358.

Sarcoidosis Mimicking Cancer Metastasis Following Chemotherapy for Ovarian Cancer

• Kim MH
• Lee K
• Kim KU
• Park HK
• Lee MK
• Suh DS

Abstract

We report on a rare case of sarcoidosis that developed after chemotherapy for ovarian cancer, and mimicked a cancer metastasis. A 52-year-old female diagnosed with stage III ovarian cancer underwent curative surgery and postoperative chemotherapy. Four months later, her whole-body positron emission tomography and computed tomography (CT) scan showed high uptake in the mediastinal lymph nodes, and ovarian cancer recurrence was suspected. Biopsy of the mediastinal lymph nodes and subcutaneous nodules revealed noncaseating granulomas. These lesions resolved spontaneously without treatment; however, newly developed perilymphatic and centrilobular nodules were observed on follow-up chest CT. Surgical biopsy of these lesions also showed noncaseating granulomas. She was finally diagnosed with sarcoidosis.

Keyword

Sarcoidosis; Ovarian neoplasms; Drug therapy; Positron-emission tomography and computed tomography

MeSH Terms

Biopsy
Drug Therapy*
Female
Follow-Up Studies
Granuloma
Humans
Lymph Nodes
Middle Aged
Neoplasm Metastasis*
Ovarian Neoplasms*
Positron-Emission Tomography and Computed Tomography
Recurrence
Sarcoidosis*
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Plain chest radiograph. (A) Plain chest radiograph before chemotherapy showed no active lung lesion. (B) Plain chest radiograph after chemotherapy showed bilateral hilar enlargement (arrows).

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  Fig. 2 Positron emission tomography and computed tomography (PET/CT) images of the lymph nodes. PET/CT scan showed multiple areas of high uptake in the enlarged paratracheal, left supraclavicular, retrocrural, and diaphragmatic lymph nodes.

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  Fig. 3 Computed tomography (CT) images of the lymph nodes (A) four months after chemotherapy and (B, C) at the follow-up. (A) CT scan of the mediastinal setting showed multiple mediastinal lymph adenopathy (arrows). (B) CT scan of the mediastinal setting showed decreased size of multiple mediastinal lymph nodes (arrows). (C) CT scan of the lung setting showed newly developed perilymphatic and centrilobular nodules in both lungs (arrows).

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  Fig. 4 Biopsy specimens showed multiple noncaseating granulomas with no evidence of malignancy. (A) Right paratracheal lymph node. (B) Subcutaneous nodule in the right arm. (C) Lung parenchyma (A-C, H&E staining, ×400).

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