Systemic Sarcoidosis With a Pseudo-Tumoral Phenotype

Donia Chebbi; Raida Ben Salah; Faten Frikha; Héla Fourati; Mariam Ghribi; Zeineb Mnif; Zouhir Bahloul

doi:10.18502/acta.v61i3.12743

Donia Chebbi Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia
Raida Ben Salah Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia
Faten Frikha Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia
Héla Fourati Department of Radiology, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia
Mariam Ghribi Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia
Zeineb Mnif Department of Radiology, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia
Zouhir Bahloul Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia

DOI: https://doi.org/10.18502/acta.v61i3.12743

Keywords: Systemic sarcoidosis; Orbital tumor; Pulmonary pseudotumor; Angiotensin converting enzyme; Corticotherapy

Abstract

Sarcoidosis is a systemic disease histologically characterized by the presence of non-caseating granulomas. Granulomas can affect all structures of the body, giving heterogeneous manifestations and making the diagnosis of this disease a real challenge. We report the case of a 72-year-old woman who presented with two rare manifestations of sarcoidosis: an orbital and a pulmonary pseudotumor. The orbital tumor revealed the disease. Clinically, the patient had palpebral swelling. Orbital MRI showed an orbital pseudotumor hypointense on T1, and hyperintense on T2, heterogeneous and enhanced after gadolinium injection. The thoracic localization was asymptomatic, revealed by the chest Computed Tomography (CT) scan. Histological evidence of granuloma was obtained at both locations. The level of angiotensin-converting enzyme was high. All the other systemic granulomatous diseases were eliminated. We started a systemic corticotherapy with good clinical results.