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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Oxaliplatin-associated sarcoid-like reaction masquerading as recurrent colon cancer
  1. Surya Kiran Aedma1,
  2. Anusha Chidharla2,
  3. Sarah Kelting3 and
  4. Anup Kasi3
  1. 1Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
  2. 2Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
  3. 3Medical Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
  1. Correspondence to Dr Anup Kasi; anupdoc{at}gmail.com

Abstract

A 54-year-old man with stage IV B metastatic colorectal cancer with liver and peritoneal metastasis was treated with cytoreductive surgery (extended left colectomy, right partial hepatectomy, resection of right diaphragm nodule) and perioperative oxaliplatin-based chemotherapy. The patient was cancer-free for 6 months, at which point a surveillance positron emission tomography-CT scan showed metabolically active hepatosplenic lesions and mediastinal and bilateral hilar lymph nodes. An endobronchial ultrasound bronchoscopy-guided fine needle aspiration of the mediastinal and hilar lymph nodes revealed non-necrotising granulomas. The workup was negative for bacterial, fungal or mycobacterial infection, cancer or autoimmune disease. Carcinoembryonic antigen and COLVERA (a circulating tumour DNA liquid biopsy test for the detection of recurrent colon cancer) tests were negative. Subsequently the rare diagnosis of a sarcoidosis-like reaction from oxaliplatin-based chemotherapy was made. Repeat imaging after 3 months showed resolution of the hepatosplenic lesions and lymphadenopathy, alike.

  • oncology
  • cancer intervention
  • contraindications and precautions

https://doi.org/10.1136/bcr-2019-229548

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    Footnotes

    • Contributors SKA was involved in reviewing the patient medical records, acquisition of data, reviewing previously published literature and drafting the manuscript. AC and SKA coordinated with other authors to streamline the content to make it clinically and scientifically meaningful. SK provided images of biopsy and figure legends. She also helped with the interpretation of data and edited the content. AK was involved in the conception and design of the case report. He revised it critically for important intellectual content before providing the final approval. He obtained patient consent. He agrees to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.