Malignancy in patients with sarcoidosis

Abstract

The relationship between sarcoidosis and malignancy is not clear yet. We retrospectively evaluated 131 sarcoidosis patients followed-up at the single Rheumatology center. The incidence of malignancies was investigated in this cohort. A total of 6 (4.6%) patients with malignancy were identified in our cohort of 131 patients with sarcoidosis. Hodgkin lymphoma (HL) was detected in three patients, followed by one patient with breast cancer, one patient with thyroid cancer and one patient with testicular cancer. All patients had chronic sarcoidosis with pulmonary involvement, and only 1 patient had acute sarcoidosis with Löfgren's syndrome. HL developed concomitantly with sarcoidosis in one patient while other two patients developed disease before and after sarcoidosis diagnosis. Two patients with solid tumors developed malignancy years before sarcoidosis diagnosis, while one patient developed thyroid cancer during sarcoidosis follow-up. All 6 sarcoidosis–malignancy patients survived after six year years follow up. We found low incidence of malignancy in patients with sarcoidosis in our small cohort. The sarcoidosis–malignancy relationship can only be a coincidence and/or can be explained by a common pathogenesis. New prospective studies involving large patients series are needed in this regard.

Resumen

La relación entre sarcoidosis y malignidad no está clara todavía. Evaluamos retrospectivamente 131 pacientes con sarcoidosis seguidos por un centro de reumatología. En esta cohorte se investigó la incidencia de neoplasias malignas. Se identificó un total de 6 (4,6%) pacientes con neoplasia maligna en esta cohorte. El linfoma de Hodgkin (LH) se detectó en 3 pacientes, seguido de un paciente con cáncer de mama, un paciente con cáncer de tiroides y un paciente con cáncer testicular. El LH se desarrolló concomitantemente con sarcoidosis en un paciente, mientras que los otros 2 desarrollaron la enfermedad antes y después del diagnóstico de sarcoidosis. Dos pacientes con tumores sólidos desarrollaron malignidad años antes del diagnóstico de sarcoidosis, mientras que el paciente con cáncer de tiroides lo presentó durante el seguimiento. Los 6 pacientes con sarcoidosis y malignidad sobrevivieron durante 6 años de seguimiento. Encontramos baja incidencia de malignidad en pacientes con sarcoidosis en nuestra cohorte. La relación sarcoidosis-malignidad puede ser coincidental y/o puede explicarse por una patogénesis común.

Introduction

Sarcoidosis is a systemic disorder of unknown etiology, which is characterized by non-caseating granuloma reaction.¹ There are contradictory data in the literature regarding the relationship between sarcoidosis and malignancy.² The reasons of those controversial results may be explained with biases in patients selection and different classification method used. Herein we reported the incidence of malignancy in a small cohort sarcoidosis patients.