title: Sarcoid-like reaction in a patient with uveitis and underlying cancer.
abstract: OBJECTIVE
  Sarcoidosis is a granulomatous disease of unknown etiology. Occasionally, triggering causes are identified, such as neoplasms, and they are termed sarcoid-like reactions, which may appear in any sarcoidotic target tissue. Choroidal metastases appear as part of widespread metastatic disease or as the first suggestion of neoplastic disease. They can also be a part of the differential diagnosis of a spectrum of inflammatory eye diseases. We present a case in which a lung carcinoma, pulmonary and eye sarcoid-like reactions, and choroidal metastasis take place in the same patient.
  
  
  METHODS
  A 60-year-old male with a past history of pulmonary sarcoidosis and associated anterior uveitis was diagnosed with a lung carcinoma with no regional lymph nodes extension, so that the resection surgery was performed without additional systemic treatment. At the same time, he complained of visual acuity loss and pain in his right eye. An intense ocular inflammatory reaction and a choroidal mass compatible with metastasis were identified. A vitrectomy with an accompanied histological exam of the lesion was deemed inconclusive. Ocular symptoms progressively worsened showing mass growth, and as a result, an enucleation was performed and the histological study subsequently revealed metastasis from his lung carcinoma.
  
  
  CONCLUSIONS
  Sarcoid-like reactions may be due to incipient malignancies. Any diagnosis of sarcoidosis requires ruling out other diseases that can produce secondary sarcoid-like reactions. In addition, any choroidal mass suggestive of metastasis requires exclusion of metastatic disease even in the absence of clinical signs indicating tumor extension.
authors.affiliation: University Hospital of León, León, Spain. i.pascualcamps@gmail.com.|University and Polytechnic Hospital La Fe, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain. i.pascualcamps@gmail.com.
authors.forename: Isabel
authors.identifier: http://orcid.org/0000-0002-2355-8029
authors.initials: I
authors.lastname: Pascual-Camps
authors.affiliation: University Hospital of León, León, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Alonso-Orcajo
authors.affiliation: University Hospital of León, León, Spain.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: de la Fuente
authors.affiliation: Dept. of Visual Services, Harvard Medical Associates, Baintree, MA, USA.
authors.forename: Taygan
authors.initials: T
authors.lastname: Yilmaz
authors.affiliation: University Hospital of León, León, Spain.|Instituto Biomedicina (IBIOMED), University of León, León, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cordero-Coma
mesh_terms: D044963:Biopsy, Fine-Needle; D001999:Bronchoscopy; D002829:Choroid / Q000000981:diagnostic imaging*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000175:diagnosis; D014463:Ultrasonography; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014821:Vitrectomy
keywords: Choroidal metastasis; Lung cancer; Sarcoid-like reaction; Sarcoidosis; Uveitis