{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T23:09:56Z","timestamp":1765667396282,"version":"3.46.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Hintergrund Granulomat\u00f6se Erkrankungen wie Sarkoidose k\u00f6nnen die Diagnostik bei onkologischen Erkrankungen erschweren, da Metastasen bildmorphologisch h\u00e4ufig nicht von Granulomen zu unterscheiden sind. Die vorliegende Kasuistik beschreibt Diagnostik und Therapie eines Patienten mit fortgeschrittener Sarkoidose und einem hepatisch metastasierten Rektumkarzinom mit schlussendlichem Erreichen eines kurativen Stadiums.<\/jats:p>\n                  <jats:p>Fallbeschreibung Bei einem 71-j\u00e4hrigen Patienten wurde im Rahmen der Abkl\u00e4rung ungewollten Gewichtsverlustes sowie einer An\u00e4mie ein Adenokarzinom des Rektums diagnostiziert. Die weitere Umfelddiagnostik ergab bildmorphologisch den hochgradigen Verdacht auf multiple rechtshepatische, pulmonale und splenische Metastasen. Histologisch zeigten sich nach bronchoskopischer Biopsie der mediastinalen Lymphknoten jedoch nichtverk\u00e4sende Epitheloidzellgranulome als Manifestation einer bis dato nicht bekannten Sarkoidose.  Aufgrund des stenosierenden Tumors erfolgte eine Rektumresektion mit Milzextirpation bei intraoperativ hochgradigem Verdacht auf Milzmetastasen. Histologisch zeigten sich in der Milz eine Beteiligung im Rahmen der Sarkoidose. Bei bildmorphologisch weiterhin suspekten rechtshepatischen Leberl\u00e4sionen erfolgte postoperativ eine Stanzbiopsie einer L\u00e4sion, die histologisch sowohl eine Metastase des bekannten Rektumkarzinoms als auch eine Sarkoidose ergab. Es erfolgte eine pseudo(neo)adjuvante Therapie mit 5-Fluorouracil, Leukovorin und Oxaliplatin (FOLFOX) und Panitumumab (Anti-EGF-Antik\u00f6rper). Bildmorphologisch zeigten sich posttherapeutisch 2 Leberl\u00e4sionen regredient, mehrere weitere gr\u00f6\u00dfenstabil. Es erfolgte eine erweiterte Hemihepatektomie rechts mit histologischem Nachweis von sowohl Metastasen als auch Sarkoidose-Herden. Der zu diesem Zeitpunkt tumorfreie Patient wurde in die engmaschige Nachsorge entlassen, die sich im weiteren Verlauf (13 Monate) bildmorphologisch ohne Rezidivhinweis zeigte.<\/jats:p>\n                  <jats:p>Diskussion Das gleichzeitige Auftreten von metastasierten Tumorerkrankungen und Sarkoidoseherden f\u00fchrt zu einem diagnostischen Dilemma, da die Manifestationen bildmorphologisch kaum unterschieden werden k\u00f6nnen. Dieser Fallbereich zeigt, dass eine umfassende histologische Aufarbeitung der unterschiedlichen betroffenen Organe mit konsekutiven Resektionen schlussendlich zu einer Tumorfreiheit des Patienten f\u00fchren kann.<\/jats:p>","DOI":"10.1055\/a-1880-1639","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T19:39:53Z","timestamp":1663702793000},"page":"515-521","source":"Crossref","is-referenced-by-count":1,"title":["Metastase oder Sarkoidose \u2013 eine diagnostische Herausforderung beim metastasierten Rektumkarzinom"],"prefix":"10.1055","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-6834","authenticated-orcid":false,"given":"Marius","family":"Brunner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, gastrointestinale Onkologie und Endokrinologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Ammer-Herrmenau","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, gastrointestinale Onkologie und Endokrinologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"Biggemann","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr diagnostische und interventionelle Radiologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Str\u00f6bel","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, gastrointestinale Onkologie und Endokrinologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Ellenrieder","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, gastrointestinale Onkologie und Endokrinologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8318-0315","authenticated-orcid":false,"given":"Golo","family":"Petzold","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, gastrointestinale Onkologie und Endokrinologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/S0140-6736(13)60680-7","volume-title":"\u201eSarcoidosis\u201c, Bd. 383, Nr. 9923","author":"D Valeyre","year":"2014"},{"key":"ref2","first-page":"543","volume-title":"\u201eMultiple benign sarcoid of the skin\u201c, Bd. 17","author":"C Boeck","year":"1899"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1055\/s-0030-1257126","volume-title":"\u201eSarkoidose\u201c Bd. 66, Nr. 02","author":"S Pabst","year":"2012"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.7247","article-title":"Coexistence of sarcoidosis and metastatic lesions: A diagnostic and therapeutic dilemma (Review)","author":"C Spiekermann","year":"2017","journal-title":"Oncol Lett"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1097\/RLU.0b013e31823eaaf0","volume-title":"\u201eFalse-Positive Bone Metastases on PET\/CT Secondary to Sarcoidosis in a Patient With Rectal Cancer\u201c, Bd. 37, Nr. 3","author":"KM Montini","year":"2012"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1111\/resp.12369","volume-title":"\u201eIs the incidence of malignancy increased in patients with sarcoidosis? 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