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Obstructive sinonasal granuloma: a rare complication of systemic sarcoidosis
  1. Amanda Walsh,
  2. Brandon Klein and
  3. Suzette Mikula
  1. Otolaryngology, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
  1. Correspondence to Dr Amanda Walsh; Amanda.r.walsh{at}


Sarcoidosis is a granulomatous disorder which presents with pulmonary involvement in >90% of cases. Sinonasal involvement is rare, occurring in 1% of all patients with sarcoidosis. It typically presents in the setting of active pulmonary disease. Here, we present a rare case of sinonasal sarcoidosis (SNS) in a patient with latent pulmonary sarcoidosis. The patient presented to our clinic with several years of nasal obstruction, rhinorrhea and cough unresponsive to medical management. Eventually, radiographic imaging was performed, revealing a large obstructive mass in the left nasal cavity. The mass was resected, and pathology demonstrated epithelioid granulomas, consistent with sarcoidosis. The patient was subsequently placed on systemic therapy with improvement in her symptoms. In summary, SNS is a rare clinical entity that infrequently presents in patients without active pulmonary involvement. Clinicians should have a low threshold to obtain imaging in patients with sarcoidosis who present with sinonasal complaints.

  • Ear, nose and throat/otolaryngology
  • nasal polyps
  • Rheumatology
  • Otolaryngology / ENT

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  • Contributors AW, BK and SM all contributed to drafting the manuscript for this case report. AW and SM were the physicians responsible for this patient’s care.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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