{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T09:53:37Z","timestamp":1770458017276,"version":"3.49.0"},"reference-count":48,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,13]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>We present a rare case of sarcoidosis with extensive bony destruction of the maxillofacial and skull base bones. A 65-year-old woman was referred with an asymptomatic, non-healing dental socket. Examination revealed an oroantral fistula that was biopsied and repaired under general anaesthesia. Investigations included plain and cross-sectional imaging. Serological tests, in particular ACE, were normal. Histology showed benign florid granulomatous inflammation. At 6 months, the patient remained asymptomatic. She was re-referred 3\u2009years later with further bony destruction of her maxilla and mandible. Repeat imaging showed intrathoracic lymphadenopathy and skull base involvement. Repeat biopsy confirmed granulomatous inflammation. Given the pulmonary, histological and radiological findings, a sarcoidosis diagnosis was made. Following multidisciplinary team meetings, the patient was treated with methotrexate and arrangements made for close monitoring. This case highlights the need for a consensus in identifying, treating and developing a follow-up protocol in such patients.<\/jats:p>","DOI":"10.1136\/bcr-2020-237105","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T11:55:37Z","timestamp":1610970937000},"page":"e237105","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Extensive bony sarcoidosis of the head and neck region: a rare presentation"],"prefix":"10.1136","volume":"14","author":[{"given":"Iman Usama","family":"Hosni","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Surgery, Chesterfield Royal Hospital, Chesterfield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavesh","family":"Karbhari","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, Derbyshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Orr","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, Chesterfield Royal Hospital, Chesterfield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Opie","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, Derbyshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082713224634000_14.1.e237105.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.07.003"},{"key":"2025082713224634000_14.1.e237105.2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.10.2104046"},{"key":"2025082713224634000_14.1.e237105.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(03)00030-6"},{"key":"2025082713224634000_14.1.e237105.4","first-page":"133","article-title":"Etiology of sarcoidosis: does infection play a role?","volume":"85","author":"Saidha","year":"2012","journal-title":"Yale J Biol Med"},{"key":"2025082713224634000_14.1.e237105.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b3206"},{"key":"2025082713224634000_14.1.e237105.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.288.6430.1557"},{"key":"2025082713224634000_14.1.e237105.7","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200001000-00012"},{"key":"2025082713224634000_14.1.e237105.8","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2567.1996.d01-683.x"},{"key":"2025082713224634000_14.1.e237105.9","doi-asserted-by":"crossref","first-page":"003","DOI":"10.1055\/s-2007-970329","article-title":"Sarcoidosis--immunopathogenetic concepts","volume":"28","author":"Zissel","year":"2007","journal-title":"Semin Respir Crit Care Med"},{"key":"2025082713224634000_14.1.e237105.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1331-y"},{"key":"2025082713224634000_14.1.e237105.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2008.03.011"},{"key":"2025082713224634000_14.1.e237105.12","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/j.1601-0825.2005.01014.x","article-title":"Oral sarcoidosis: a review of literature","volume":"11","author":"Suresh","year":"2005","journal-title":"Oral Dis"},{"key":"2025082713224634000_14.1.e237105.13","first-page":"69","article-title":"Sarcoidosis and mycobacterial L-forms. 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