Abstract
Introduction: Although the association between cancer and sarcoidosis or sarcoid reaction is known, sarcoid reaction associated with Merkel cell carcinoma is rare. Case presentation: We report the case of a 57-year-old Japanese woman with Merkel cell carcinoma in the inguinal area associated with sarcoid reaction. Fluorodeoxyglucose positron emission tomography demonstrated elevated fluorodeoxyglucose uptake by mediastinal lymph nodes and at the carcinoma site. Histopathologically, the mediastinal lymph nodes contained no Merkel cell carcinoma components. Sarcoid lesions were identified. Systemic examinations returned no sarcoidosis-specific findings. Conclusion: Fluorodeoxyglucose positron emission tomographic scans can be used to assess neoplastic lesions and depict sarcoidosis. Sarcoid reactions must be considered in the interpretation of fluorodeoxyglucose positron emission tomographic scans.
Highlights
The association between cancer and sarcoidosis or sarcoid reaction is known, sarcoid reaction associated with Merkel cell carcinoma is rare.Case presentation: We report the case of a 57-year-old Japanese woman with Merkel cell carcinoma in the inguinal area associated with sarcoid reaction
Sarcoid reactions must be considered in the interpretation of fluorodeoxyglucose positron emission tomographic scans
We present the case of a patient with Merkel cell carcinoma associated with sarcoid reaction
Summary
Sarcoidosis, a common systemic disorder of unknown etiology, is characterized by the formation of non-caseating epithelioid cell granulomas. A diagnosis of sarcoid reaction is made when localized epithelioid granulomas are found without signs of systemic sarcoidosis. They are attributable to infections, foreign materials, gastrointestinal diseases and malignant tumors [1]. Case presentation A 57-year-old Japanese woman presented to our hospital with a painless, firm, palpable mass 3 cm in diameter of five months’ duration in the left inguinal area She was a non-smoker and had no particular respiratory symptoms. The sentinel lymph node in her left groin was excised and the mediastinal lymph nodes were dissected by performing video-assisted thoracic surgery Her Merkel cell carcinoma was found to have. These findings were suggestive of sarcoidosis or sarcoid reaction (Figure 3). The patient is being followed every three months and is free of relapse two years after the initial diagnosis
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