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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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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
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author Alhashimalsayed, Zaki
Ladak, Karim
Al-Haddad, Sahar
Kraeker, Christian
author_facet Alhashimalsayed, Zaki
Ladak, Karim
Al-Haddad, Sahar
Kraeker, Christian
author_sort Alhashimalsayed, Zaki
collection PubMed
description 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.”
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spelling pubmed-105404932023-09-30 The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System Alhashimalsayed, Zaki Ladak, Karim Al-Haddad, Sahar Kraeker, Christian Cureus Internal Medicine 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.” Cureus 2023-08-30 /pmc/articles/PMC10540493/ /pubmed/37779737 http://dx.doi.org/10.7759/cureus.44401 Text en Copyright © 2023, Alhashimalsayed et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Alhashimalsayed, Zaki
Ladak, Karim
Al-Haddad, Sahar
Kraeker, Christian
The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System
title The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System
title_full The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System
title_fullStr The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System
title_full_unstemmed The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System
title_short The Great Imitator: A Case of Multisystem Sarcoidosis Involving the Genitourinary System
title_sort great imitator: a case of multisystem sarcoidosis involving the genitourinary system
topic Internal Medicine
url 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
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