title: Sarcoidosis of the vagina treated with methotrexate.
abstract: We describe the first case of mediolateral episiotomic sarcoidosis of the deep vaginal tissue, without involvement of the pulmonary parenchyma or pulmonary symptoms. A 68-year-old female was admitted with a vaginal mass that had developed about 1 month prior. On bimanual examination, we found a painful solid mass approximately 4 cm in diameter on the episiotomy line of the deep vaginal tissue. The patient underwent pelvic magnetic resonance imaging on suspicion of a malignancy, and a vaginal true-cut biopsy was performed. The biopsy specimen exhibited non-caseating, granulomatous inflammation and many multinucleated giant cells, strongly suggesting sarcoidosis. We had excluded other granulomatous diseases; a final diagnosis was made of stage-1 sarcoidosis in the deep vaginal mass. A 3-month course of methotrexate (2.5 mg/week) was commenced to treat a flare-up of rheumatoid arthritis. The vaginal mass resolved. To the best of our knowledge, this is the first case of sarcoidosis in a deep vaginal mass without pulmonary parenchymal or other solid-organ involvement.
authors.affiliation: a Department of Obstetrics and Gynecology , Sifa University Medicine School , Izmir , Turkey ;
authors.forename: N
authors.initials: N
authors.lastname: Şahin
authors.affiliation: b Department of Radiodiagnostic , Sifa University Medicine School , Izmir , Turkey ;
authors.forename: A
authors.initials: A
authors.lastname: Solak
authors.affiliation: c Department of Pathology , Sifa University Medicine School , Izmir , Turkey ;
authors.forename: S
authors.initials: S
authors.lastname: Karaarslan
authors.affiliation: d Department of Thoracic Medicine , Sifa University Medicine School , Izmir , Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Doruk
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D001706:Biopsy; D004841:Episiotomy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000627:therapeutic use*; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D014621:Vagina / Q000473:pathology; D014623:Vaginal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000964:Antimetabolites, Antineoplastic; D007166:Immunosuppressive Agents; D008727:Methotrexate
keywords: Sarcoidosis; methotrexate; vaginal involvement