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The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System

Sarcoidosis is a multisystem noncaseating granulomatous disease, which primarily involves the lungs, skin, and lymph nodes. In this case, we describe a 49-year-old Caucasian male presenting with weakness and symptomatic hypercalcemia. Initial workup revealed multiple testicular hypoechoic lesions on...

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Detalles Bibliográficos
Autores principales: Alhashimalsayed, Zaki, Ladak, Karim, Al-Haddad, Sahar, Kraeker, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540493/
https://www.ncbi.nlm.nih.gov/pubmed/37779737
http://dx.doi.org/10.7759/cureus.44401
Descripción
Sumario:Sarcoidosis is a multisystem noncaseating granulomatous disease, which primarily involves the lungs, skin, and lymph nodes. In this case, we describe a 49-year-old Caucasian male presenting with weakness and symptomatic hypercalcemia. Initial workup revealed multiple testicular hypoechoic lesions on ultrasound and pulmonary nodules with hilar lymphadenopathy on a CT scan. Given the age of the patient, the initial differential diagnosis included lymphoma and testicular cancer. However, a lymph node biopsy confirmed the presence of noncaseating granulomas, and thus a diagnosis of multisystem sarcoidosis was made. Treatment with systemic steroids resulted in significant improvement, and he was initiated on methotrexate as a steroid-sparing agent. This case report details an unusual presentation of this multisystemic disease, which infrequently involves the genitourinary system, and presents a review of the literature on the “great imitator.”