Abstract
Sarcoidosis is a systemic disease that histologically typically shows non-caseating granulomas. The most common radiologic finding is hilar and mediastinal adenopathy. Patients with widely disseminated disease may show involvement of the peripheral appendicular skeleton in 1–13% of such cases. A primary skeletal presentation without other manifestations typical of the disease is rare. We present a case of sarcoidosis in a middle-aged Caucasian man in whom the disease presented with widespread lytic lesions in the axial skeleton and long bones, mimicking metastatic disease. There was no involvement of the peripheral skeleton, skin or lungs.
Similar content being viewed by others
References
Koyama T, Ueda H, Togashi K, Umeoka S, Kataoka M, Nagai S. Radiologic manifestations of sarcoidosis in various organs. Radiographics 2004; 24: 87–104.
Hosoda Y, Sasagawa S, Yasuda N. Epidemiology of sarcoidosis: new frontiers to explore. Curr Opin Pulm Med 2002; 8: 424–428.
Liebow A. Pulmonary angiitis and granulomatosis. Am Rev Resp Dis 1973; 108: 1–18.
Bodie BF, Kheir SM, Omura EF. Calvarial sarcoid mimicking metastatic disease. J Am Acad Dermatol 1980; 3: 401–405.
Sartoris DJ, Resnick D, Resnik C, Yaghmai I. Musculoskeletal manifestations of sarcoidosis. Semin Roentgenol 1985; 4: 376–388.
Mana J, Segarra MI, Casas R, Mairal L, Fernandez-Nogues F. Multiple atypical bone involvement in sarcoidosis. J Rheumatol 1993; 20: 394–396.
Nunes H, Brillet P, Valeyre D, Brauner M, Wells A. Imaging in sarcoidosis. Semin Respir Crit Care Med 2007; 28: 102–120.
Holt J, Owens W. The osseous lesions of sarcoidosis. Radiology 1949; 53: 11–29.
Yakushiji Y, Yamada K, Nagatsuka K, Hashimoto Y, Miyashita K, Naritomi H. “A girdle-like tightening sensation” misapprehended as abdominal splanchnopathy in a sarcoidosis patient. Intern Med 2005; 44: 647–652.
Slart RM, de Jong JW, Haeck PWE. Lytic skull lesions and symptomatic hypercalcaemia in bone marrow sarcoidosis (letter to the editor). Ann Intern Med 1999; 246: 117–123.
Shetty A, Gedalia A. Sarcoidosis. Emedicine.com 2006.
Mangino D, Stover D. Sarcoidosis presenting as metastatic bony disease. Respiration 2004; 71: 292–294.
Resnik C, Young J, Aisner S, Levine A. Case report 594. Skeletal Radiol 1990; 19: 79–81.
Packer C, Mileti L. Vertebral sarcoidosis mimicking lytic osseous metastases: development 16 years after apparent resolution of thoracic sarcoidosis. J Clin Rheumatol 2005; 11: 105–108.
Aberg C, Ponzo F, Raphael B, Amorosi E, Moran V, Kramer E. Case report—FDG positron emission tomography of bone involvement in sarcoidosis. AJR Am J Roentgenol 2004; 182: 975–977.
Gonzalez del Pino J, Diez Ulloa A, Lovic A, Relea M. Sarcoidosis of the hand and wrist: a report of two cases. J Hand Surg [Am] 1997; 22: 942–945.
Ludwig V, Fordice S, Lamar R, Martin W, Delbeke D. Unsuspected skeletal sarcoidosis mimicking metastatic disease on FDG positron emission tomography and bone scintigraphy. Clin Nucl Med 2003; 28: 176–179.
Nishiyama Y, Yamamoto Y, Fukunaga K, et al. Comparative evaluation of 18F-FDG-PET and Ga67 scintigraphy in patients with sarcoidosis. J Nucl Med 2006; 47: 1571–1576.
Acknowledgement
The authors would like to thank Dr. Vincent Pellegrini (Orthopaedic Surgery), Dr. Navin Todd (Pulmonary Medicine) and Dr. Jon Finan (Anatomic Pathology) for their contributions to this patient’s care.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Talmi, D., Smith, S. & Mulligan, M.E. Central skeletal sarcoidosis mimicking metastatic disease. Skeletal Radiol 37, 757–761 (2008). https://doi.org/10.1007/s00256-008-0479-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-008-0479-7