Sarcoidosis of the female genital tract

Česká verzia

Authors: A. Šefčíková ¹; M. Turková ²; M. Žurková ³
Authors place of work: Porodnicko-gynekologické oddělení Slezské nemocnice, Opava, primář MUDr. A. Dörr, CSc. ¹; Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. ²; Klinika plicních nemocí a tuberkulózy FN a LF UP, Olomouc, přednosta prof. MUDr. V. Kolek, DrSc. ³
Published in the journal: Ceska Gynekol 2016; 81(6): 458-462

Summary

Objective:
To present the findings of sarcoidosis on female genital tract.

Design:
Review.

Setting:
Department of Obstetric and Gynecology, Silesian Hospital Opava.

Methods:
Overview of published findings from case studies.

Conclusion:
Sarcoidosis is a multisystem granulomatous disorder of unclear cause. It typically involves the lymph nodes of mediastinum, predominantly billateral and/or pulmonary infiltrates. We find extrapulmonary involvement in 30–50% of cases. Sarcoidosis of the female reproductive system is a rare, it represent less than 1% cases of sarcoidosis. Lesions there may affect any organ, including the vulva, vagina, cervix, uterus, fallopian tube and ovary, but also for example placenta and breast. There is also recorded the incidence of multiple localization on female genitalia. Since sarcoidosis of this area is so rare, often proceeds asymptomatic and recognized only as an incidental finding, there are mention only the case histories in literature yet.

Clinical symptoms may be non-specific, often imitating a tumor, or tend to be specific, depending on the localization of disability such as perineal pain, pain in the scar after the previous birth trauma, persistent pruritus, itching, irritation, dyspareunia, menstrual cycle disorders, menorrhagia, metrorrhagia, postmenopausal bleeding, amenorrhoe, abdominal pain, endometrial polypoid lesions, recurrent or persistent serometra or discharge. The diagnosis is made up of histologically – we are demonstrating noncaseating granulomas.

The therapy is difficult, there are no available official guidelines. If the lesions are clinically silent, we can observed them because they may spontaneously disappear. If we are embarking on medical therapy, we start from a local application, and if this is unsuccessful then we approach the systemic administration. Corticosteroids are the drug of choice. If we diagnose the sarcoidosis of the female genital organs we must exclude systemic disease of sarcoidosis. The prognosis of disease is good.

Keywords:
extrapulmonary sarcoidosis, sarcoidosis of the female reproductive tract, granulomatous disease

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