CARCINOID-TUMORS AND SARCOIDOSIS - DOES A LINK EXIST

Objective: To attempt to determine whether a relationship exists betwe en carcinoid tumors and sarcoidosis. Material and Methods: We present a series of seven case reports and discuss hypotheses about possible d isease associations. Results: Certain malignant lesions have tended to occur in patients with sarcoidosis. Seven patients who were encounter ed at Mayo Clinic Rochester between 1950 and 1994 had both sarcoidosis and carcinoid tumors. These patients ranged in age from 31 to 66 year s, and three of the patients had a history of benign thyroid disorders . Malignant tumors have been thought to be related to sarcoidosis in o ne of two ways: (1) immunologic abnormalities in sarcoidosis may promo te the development of neoplasms or (2) malignant disease may promote t he onset of sarcoidosis either by causing local sarcoid reactions that progress or by directly initiating the manifestations of systemic sar coidosis. Because the chronology of events differed in our seven cases , various mechanisms of action may have a role in the manifestations o f these two disease entities. Our cases emphasize the importance of av oiding the diagnosis of disseminated malignant disease in patients wit h cancer and associated hilar and mediastinal lymphadenopathy without biopsy confirmation of metastatic disease. Conclusion: Application of the knowledge gained about the mechanisms of disease in sarcoidosis wi ll perhaps facilitate identification of the pathogenesis of carcinoid tumors and other neuroendocrine tumors.