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Open Access Case Report

Scar sarcoidosis on a finger mimicking a rapidly growing soft tissue tumour: a case report

Marcel-Philipp Henrichs1*, Arne Streitbürger1, Georg Gosheger1, Carsten Surke2, Christian Dierkes3 and Jendrik Hardes1

Author Affiliations

1 Department of General Orthopaedics and Tumourorthopaedics, University Hospital Münster, Münster, Germany

2 Department of Traumatology, Reconstructive- and Handsurgery, University Hospital Münster, Münster, Germany

3 Centre for Histology, Cytology and Molecular Diagnostics, Trier, Germany

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BMC Research Notes 2012, 5:545  doi:10.1186/1756-0500-5-545

Published: 2 October 2012

Abstract

Background

Scar sarcoidosis is a rare and uncommon but specific cutaneous manifestation of sarcoidosis. In general it arises in pre-existing scars deriving from mechanical traumas. As most surgeons dealing with scars might not be aware of cutaneous sarcoidosis and its different types of appearance the appropriate staging and treatment might be missed or at least delayed. To our knowledge this is the first case in literature of scar sarcoidosis on a finger.

Case presentation

We present a case of a 33-year-old carpenter who developed scar sarcoidosis on his right index finger 4 years after the tendon of the long digital flexor got accidentally cut by an angle grinder. He was referred due to a swelling of the finger suspected to be a malignant soft tissue tumour. The circumference of the affected finger had almost doubled, adding up to 94 mm. Incision biopsy revealed typical noncaseating granulomas. Further investigation showed a systemic extent of the disease with involvement of the lung. A systemic treatment with oral steroids led to an almost full regression of the swelling with restoration of function and resolution of lung infiltrates.

Conclusion

In case of a suspicious and/or progressive swelling a definite diagnosis should be achieved by biopsy within a short time to enable a proper treatment. If scar sarcoidosis is proven further investigation is necessary to exclude a systemical involvement. A surgical treatment of the swelling is not indicated.

Keywords:
Scar sarcoidosis; Index finger; Soft tissue sarcoma; Systemic therapy