A rare case of peritoneal sarcoidosis in a 36-year-old construction worker

Our plain-English summary of A rare case of peritoneal sarcoidosis in a 36-year-old construction worker, by S. Chubineh, K. Katona (Case Reports in Gastroenterology, 2008).

The study

• Authors: S. Chubineh, K. Katona
• Journal: Case Reports in Gastroenterology
• Published: 2008;2(3):369-72
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A 36-year-old man was admitted for persistent abdominal pain and weight loss. He had had significant exposure to asbestos, as he had been active in cleanup after the World Trade Center attack. A CT scan of his abdomen was initially read as peritoneal carcinomatosis without evidence of ascites. Infectious etiology was subsequently ruled out and diagnostic laparoscopy was performed for tissue diagnosis revealing noncaseating granulomas consistent with peritoneal sarcoidosis. Of note, he had an elevated CA-125 level on admission, which is unique in males with peritoneal sarcoidosis.

In plain English

This article was a case report about one patient, a 36-year-old man treated at North Shore University Hospital in Manhasset, New York. He had had abdominal pain for one month, an unexplained 20-pound weight loss over two months, fever, night sweats and nausea. He had worked in construction, had worked for an asbestos removal agency for five years, ten years before he came to hospital, and had spent hours daily at Ground Zero in the cleanup after the World Trade Center attack. A CT scan of his abdomen was read as extensive peritoneal carcinomatosis, meaning cancer spread over the abdominal lining. His CA-125, a blood marker, was 126 U/ml, four times the upper limit of normal. Tuberculosis testing was negative. At surgery no malignant cells were found. The final tissue examination showed noncaseating granulomas consistent with peritoneal sarcoidosis. He was discharged without steroids, and his pain eventually resolved. The authors believed this was the first reported man with peritoneal sarcoidosis and an elevated CA-125. They stated that whether his asbestos exposure was related to his sarcoidosis was uncertain.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 36-year-old man, described as a construction worker, seen at North Shore University Hospital, Manhasset, New York; published 2008
• Exposure: Dust and asbestos exposure from construction work, five years with an asbestos removal agency ending ten years before presentation, and hours daily at Ground Zero in the World Trade Center cleanup; fiber type not stated. He also had an eight pack-year smoking history.
• Main results:
  • A CT scan of the patient's abdomen showed extensive peritoneal carcinomatosis without ascites.
  • The patient's CA-125 was elevated at 126 U/ml, four times the upper limit of normal.
  • Tuberculosis workup was negative, and no malignant cells were found at surgery.
  • Final histology showed noncaseating granulomatous disease consistent with peritoneal sarcoidosis.
  • The patient's chest CT was normal and he had no respiratory complaints.
  • The patient was discharged without steroids, his abdominal pain eventually resolved, and he regained about ten pounds over four weeks.
• The authors' conclusion: The authors stated that, to their knowledge, this was the first reported case of a man with peritoneal sarcoidosis and an elevated CA-125 level. They suggested that peritoneal sarcoidosis be considered when infectious and malignant causes of peritoneal nodules are excluded, and that CA-125 be considered in the workup.
• Limitations the authors state:
  • The authors stated it is uncertain whether asbestos exposure was related to this patient's sarcoidosis, and they found no such correlation in the literature.
  • The authors noted it is unknown whether other reported cases had CA-125 testing.

Topics

Medical terms in this study, explained in our Lexicon: CT Scan, Ascites, Etiology, Diagnostic Laparoscopy, Granuloma, CA-125.

Related studies

• Malignant peritoneal mesothelioma in a 16-year-old girl: presentation of a rare disease — I.B. Brecht, A. Agaimy, et al. (2012)
• All-cause and cause specific mortality in a cohort of 20 000 construction workers; results from a 10 year follow up — V. Arndt, D. Rothenbacher, et al. (2004)
• Asbestos-induced peritoneal mesothelioma in a construction worker — R. Fonte, S. Gambettino, et al. (2004)
• A Rare Case of Pulmonary Mucoepidermoid Carcinoma in an 81-Year-Old Male — M. Abdalla, P. Sinyagovskiy, et al. (2018)
• Solitary benign fibrous mesothelioma of the peritoneum: A rare entity in a 2-year-old child — S. Singh, M. Sangwan, et al. (2016)
• Loss of BAP1 expression is very rare in peritoneal and gynecologic serous adenocarcinomas and can be useful in the differential diagnosis with abdominal mesothelioma — J. Andrici, J. Jung, et al. (2016)

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