Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report
Abstract Background Sarcoidosis is a multisystemic granulomatous disorder, which in nearly all cases involves the lungs and other organs. Isolated forms of sarcoidosis within the muscles, but without lung involvement, are extremely rare and can lead to delayed or even false diagnosis. Case presentat...
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doaj-e88d3d346175454da31e1f02e0aea6e82020-11-24T21:54:21ZengBMCJournal of Medical Case Reports1752-19472017-08-011111410.1186/s13256-017-1403-3Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case reportNiklaus Meyer0Reto Sutter1Udo Schirp2Andreas Gutzeit3Institute of Surgery, Kantonsspital WinterthurInstitute of Radiology, University Hospital BalgristInstitute of Radiology and Nuclear Medicine, Hirslanden Klinik St. AnnaInstitute of Radiology and Nuclear Medicine, Hirslanden Klinik St. AnnaAbstract Background Sarcoidosis is a multisystemic granulomatous disorder, which in nearly all cases involves the lungs and other organs. Isolated forms of sarcoidosis within the muscles, but without lung involvement, are extremely rare and can lead to delayed or even false diagnosis. Case presentation A 52-year-old white, Swiss man presented with painful arm cramps and a history of symptoms over the previous 3 years. In the initial clinical investigation, our patient also showed edema in both legs without any other complaints. After performing an magnetic resonance imaging scan of his extremities and a positron emission tomography/computed tomography scan, diffuse myositis was described. The subsequent muscle biopsy provided the surprising diagnosis of muscle sarcoidosis, without involvement of the lungs or any other organ. After starting therapy with glucocorticoids, his symptoms improved immediately. Conclusions Sarcoidosis is a common disorder, which in most cases affects the lungs. In this case report an isolated sarcoidosis is described without lung involvement, but with involvement of the muscles of the extremities and the trunk. Reported cases of sarcoidosis only involving skeletal muscle and without lung involvement are extremely rare. Radiologists should consider this presentation of sarcoidosis to avoid delayed diagnosis and therapy.http://link.springer.com/article/10.1186/s13256-017-1403-3SarcoidosisMyositisMuscle sarcoidosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Niklaus Meyer Reto Sutter Udo Schirp Andreas Gutzeit |
spellingShingle |
Niklaus Meyer Reto Sutter Udo Schirp Andreas Gutzeit Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report Journal of Medical Case Reports Sarcoidosis Myositis Muscle sarcoidosis |
author_facet |
Niklaus Meyer Reto Sutter Udo Schirp Andreas Gutzeit |
author_sort |
Niklaus Meyer |
title |
Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report |
title_short |
Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report |
title_full |
Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report |
title_fullStr |
Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report |
title_full_unstemmed |
Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report |
title_sort |
extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report |
publisher |
BMC |
series |
Journal of Medical Case Reports |
issn |
1752-1947 |
publishDate |
2017-08-01 |
description |
Abstract Background Sarcoidosis is a multisystemic granulomatous disorder, which in nearly all cases involves the lungs and other organs. Isolated forms of sarcoidosis within the muscles, but without lung involvement, are extremely rare and can lead to delayed or even false diagnosis. Case presentation A 52-year-old white, Swiss man presented with painful arm cramps and a history of symptoms over the previous 3 years. In the initial clinical investigation, our patient also showed edema in both legs without any other complaints. After performing an magnetic resonance imaging scan of his extremities and a positron emission tomography/computed tomography scan, diffuse myositis was described. The subsequent muscle biopsy provided the surprising diagnosis of muscle sarcoidosis, without involvement of the lungs or any other organ. After starting therapy with glucocorticoids, his symptoms improved immediately. Conclusions Sarcoidosis is a common disorder, which in most cases affects the lungs. In this case report an isolated sarcoidosis is described without lung involvement, but with involvement of the muscles of the extremities and the trunk. Reported cases of sarcoidosis only involving skeletal muscle and without lung involvement are extremely rare. Radiologists should consider this presentation of sarcoidosis to avoid delayed diagnosis and therapy. |
topic |
Sarcoidosis Myositis Muscle sarcoidosis |
url |
http://link.springer.com/article/10.1186/s13256-017-1403-3 |
work_keys_str_mv |
AT niklausmeyer extensiveintramuscularmanifestationofsarcoidosiswithinitiallymisseddiagnosisanddelayedtherapyacasereport AT retosutter extensiveintramuscularmanifestationofsarcoidosiswithinitiallymisseddiagnosisanddelayedtherapyacasereport AT udoschirp extensiveintramuscularmanifestationofsarcoidosiswithinitiallymisseddiagnosisanddelayedtherapyacasereport AT andreasgutzeit extensiveintramuscularmanifestationofsarcoidosiswithinitiallymisseddiagnosisanddelayedtherapyacasereport |
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