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Lung India Official publication of Indian Chest Society  
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CASE REPORT
Year : 2020  |  Volume : 37  |  Issue : 5  |  Page : 437-440

A red herring, a wild-goose chase, and an unexpected diagnosis of concomitant malignancy and sarcoidosis


1 Department of Respiratory Medicine, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
2 Department of General Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
3 Department of Urology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
4 Department of Surgical Oncology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
5 Department of Medical Oncology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
6 Department of Cardiothoracic and Vascular Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
7 Department of Pathology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India

Correspondence Address:
Dr. Padmanabhan Arjun
Department of Respiratory Medicine, Kerala Institute of Medical Sciences, Anayara P.O, Trivandrum - 695 029, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/lungindia.lungindia_378_19

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A 49-year-old male was evaluated in our hospital for chronic cough, cervical lymphadenopathy, and a testicular mass. As a part of the management, he underwent a cervical lymph node biopsy, which showed metastatic deposits from papillary carcinoma thyroid. Subsequently, he underwent orchidectomy for suspected testicular malignancy, but the biopsy showed discrete granulomatous inflammation consistent with sarcoidosis. This was followed by total thyroidectomy with neck node dissection. Nodal histopathological examination, this time, revealed a single node containing both malignancy and granulomas. Prior to the thyroid surgery, he underwent a mediastinoscopic sampling of the mediastinal nodes, which also showed granulomatous inflammation consistent with sarcoidosis. Sarcoidosis affecting the genitourinary system is a rare entity. The coexistence of sarcoidosis and thyroid malignancy poses a diagnostic challenge. A thorough review of the literature was done, and there are no reports from India on the above association. This is a unique case, which could possibly suggest an association between sarcoidosis and malignancy and highlights the importance of obtaining a tissue diagnosis in such cases.


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