title: Osteolysis of unknown origin: a case report.
abstract: BACKGROUND
  Sarcoidosis is a granulomatous disease that may affect any organ of the body. The most frequent loci of manifestation are the lungs. However, there are individual cases where bones are affected. The literature describes cases in which swelling or fistula were the first findings of a bone lesion. This is the first case reporting an osteolysis in both angles of the mandibles which led to the diagnosis of sarcoidosis with multi-organ involvement.
  
  
  METHODS
  The authors present a 74 years old European female patient without previous diagnosis of sarcoidosis who presented with pain in the area of the jaw angles. There were no further clinical symptoms. Bone biopsy following radiological investigation demonstrated non-caseating granulomas consistent with sarcoidosis of the bone. Further evaluation confirmed multi-organ disease with involvement of lungs, intrathoracic lymph nodes, and the central nervous system.
  
  
  CONCLUSIONS
  This case report shows that diagnosis of a severe disease can be missed if systematic clinical signs are not given. Furthermore, an accurate anamnesis and examination is required to receive an early diagnosis which often needs an interdisciplinary approach.
authors.affiliation: Clinic for Craniomaxillofacial and Oral Surgery, University Hospital Basel, Spitalstrasse 21 4031, Basel, Switzerland. matthias.wiesli@usb.ch.
authors.forename: Matthias Guido
authors.initials: MG
authors.lastname: Wiesli
authors.affiliation: Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4 4031, Basel, Switzerland. katrin.hostettler@usb.ch.
authors.forename: Katrin E
authors.initials: KE
authors.lastname: Hostettler
authors.affiliation: Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4 4031, Basel, Switzerland. michael.tamm@usb.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Tamm
authors.affiliation: Clinic for Craniomaxillofacial and Oral Surgery, University Hospital Basel, Spitalstrasse 21 4031, Basel, Switzerland. claude.jaquiery@usb.ch.
authors.forename: Claude
authors.initials: C
authors.lastname: Jaquiéry
mesh_terms: D000368:Aged; D001842:Bone and Bones / Q000473:pathology*; D005260:Female; D006801:Humans; D010014:Osteolysis / Q000175:diagnosis*; D012507:Sarcoidosis / Q000175:diagnosis*