title: Co-existing sarcoidosis confounds the staging of bilateral renal cell carcinoma.
abstract: We present a case in which the undiagnosed condition of sarcoidosis complicated the staging of bilateral, subtype-discordant renal cell carcinoma. Initially thought to have metastatic renal cell carcinoma based on computed tomography imaging and referred for immunotherapy, a positron emission tomography/computed tomography scan demonstrated different levels of radiotracer activity in the primary site and the presumed pulmonary metastatic sites. The patient underwent bilateral partial nephrectomies and was ultimately diagnosed with stage T1 bilateral renal cell carcinoma and sarcoidosis. This case highlights the need to consider concurrent medical conditions that can lead to false positive results when evaluating for metastatic disease with imaging studies as well as the importance of evaluating the levels of radiotracer activity between different sites.
authors.affiliation: Department of Surgery, Division of Urology, University of Utah Health Sciences Center, 30 North 1900 East, Salt Lake City, UT 84132, USA. Heather.willis@hsc.utah.edu
authors.forename: Heather
authors.initials: H
authors.lastname: Willis
authors.forename: Marta
authors.initials: M
authors.lastname: Heilbrun
authors.forename: Christopher
authors.initials: C
authors.lastname: Dechet
mesh_terms: D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D004238:Diverticulitis / Q000150:complications; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D019275:Radiopharmaceuticals; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18