title: Sarcoidosis manifesting as hepatic and splenic nodules mimicking ovarian cancer metastases: A case report.
abstract: The current study presents a case of sarcoidosis manifesting as hepatic and splenic nodules, which was difficult to differentiate from ovarian cancer metastases. A 24-year-old female, who was previously diagnosed with right ovarian cancer and underwent surgery at the age of 21, was found to have two nodules in the spleen revealed by contrast-enhanced computed tomography (CT).18F-fluorodeoxyglucose positron emission tomography/CT revealed two abnormal high uptake lesions in the spleen and one abnormal high uptake lesion in the liver. Under a diagnosis of hepatic and splenic metastases from right ovarian cancer, a laparoscopic splenectomy and partial hepatectomy were performed. Histopathological examination showed that a large number of non-caseating epithelioid cell granulomas formed these nodules, which was compatible with sarcoidosis. This case indicates that it is difficult to distinguish sarcoidosis from metastatic disease even using the latest modalities, and that laparoscopic surgery is a minimally invasive and useful tool for forming a differential diagnosis.
authors.affiliation: Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan ; Department of Surgery, Nagahama City Hospital, Nagahama, Shiga 526-8580, Japan.
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Yonenaga
authors.affiliation: Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Fumiki
authors.initials: F
authors.lastname: Kushihata
authors.affiliation: Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Jota
authors.initials: J
authors.lastname: Watanabe
authors.affiliation: Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Tohyama
authors.affiliation: Pathology Division, Ehime University Hospital, Toon, Ehime 791-0295, Japan.
authors.forename: Atsuro
authors.initials: A
authors.lastname: Sugita
authors.affiliation: Department of Hepatobiliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Takada
keywords: hepatic involvement; laparoscopic surgery; ovarian cancer metastasis; sarcoidosis; splenic involvement