Genital Sarcoidosis as the Presenting Feature of the Disease: a Case Report

We report the case of a 12 year old girl who presented with a relatively large nodule in her clitoris, which was later proven to be an unusual presentation of sarcoidosis. She was admitted because of fever, dysuria, frequency, vaginal irritation and itching without a favorable response to the previous antibacterial treatment. She had a history of intermittent dry cough during the last three months before admission. Two days after her admission, she also developed bilateral parotid enlargement. Spiral CT scan of the neck showed diffuse parotid and submandibular glands enlargement with bilateral enlarged lymph nodes. Spiral CT scan of the chest revealed bilateral hilar lymphadenopathy with a non-infectious pattern of pneumonitis. Biopsy of the lesions was indicative of granulomatous infiltration mostly in favor of sarcoidosis. The patient was also evaluated for other conditions associated with pathologic features of granulomatous inflammation. The findings were negative except for a significantly elevated serum angiotensin converting enzyme. Sarcoidosis was considered as the diagnosis and she was successfully treated with prednisolone.