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Initial brain biopsy showed non-specific vascular lesions and inflammation which were initially thought secondary to sarcoidosis since there was no evidence of malignancy. However, given the importance of a definitive diagnosis to establish prognosis, repeat brain biopsy was pursued, which confirmed metastatic lung cancer. This case demonstrates the benefits of repeat biopsy in situations where clinical suspicion for malignancy is high, as well as the possibility for multiple concurrent diagnoses in a patient. The patient is currently undergoing stereotactic radiosurgery and chemotherapy with carboplatin, pemetrexed and pembrolizumab.<\/jats:p>","DOI":"10.1136\/bcr-2024-260212","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:41:29Z","timestamp":1730288489000},"page":"e260212","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Concurrent sarcoidosis and metastatic lung cancer in a patient with ring-enhancing brain lesions"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2381-0343","authenticated-orcid":false,"given":"Mariam","family":"Ardehali","sequence":"first","affiliation":[{"name":"School of Medicine, Duke University School of Medicine, Durham, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Dussault","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Howe","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saumil","family":"Chudgar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"2025082800525120000_17.10.e260212.1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9082363","article-title":"Clinical Presentations, Pathogenesis, and Therapy of Sarcoidosis: State of the Art","volume":"9","author":"Polverino","year":"2020","journal-title":"J Clin Med"},{"key":"2025082800525120000_17.10.e260212.2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201511-760OC"},{"key":"2025082800525120000_17.10.e260212.3","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000715"},{"key":"2025082800525120000_17.10.e260212.4","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1001\/jamaoncol.2021.4932","article-title":"Update of Incidence, Prevalence, Survival, and Initial Treatment in Patients With Non-Small Cell Lung Cancer in the US","volume":"7","author":"Ganti","year":"2021","journal-title":"JAMA Oncol"},{"key":"2025082800525120000_17.10.e260212.5","doi-asserted-by":"crossref","first-page":"S253","DOI":"10.1016\/j.lungcan.2004.07.967","article-title":"Treatment of brain metastases from lung cancer: chemotherapy","volume":"45 Suppl 2","author":"Schuette","year":"2004","journal-title":"Lung Cancer"},{"key":"2025082800525120000_17.10.e260212.6","doi-asserted-by":"crossref","unstructured":"El Jammal T , Pavic M , Gerfaud-Valentin M , et al . n.d. 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