Chronic rhinosinusitis revealing a nasal sarcoidosis: A case report

Abstract

Sarcoidosis is a systemic inflammatory disease characterized by the formation of noncaseating granulomas. While commonly affecting the lungs and lymph nodes, nasosinusal involvement is rare, accounting for less than 1% of cases. When the nasosinusal region is affected, clinical manifestations may include persistent nasal obstruction, epistaxis, anosmia, and facial. Diagnosis relies on imaging studies, which may reveal mucosal thickening or destructive lesions, and histopathological confirmation through biopsy. Management typically involves systemic corticosteroids, with immunosuppressive agents reserved for refractory cases. This uncommon localization can mimic other inflammatory or infectious conditions, underscoring the importance of accurate diagnosis for appropriate treatment. We report the case of a 55-year-old female patient with a history of chronic rhinosinusitis persisting for 2 years despite conventional treatment, who presented to our facility with a clinical picture of chronic nasal obstruction rhinorrhea and anosmia. Clinical, laboratory, and imaging investigations confirmed the diagnosis of nasosinusal sarcoidosis. Given the rarity of this condition, maintaining a high index of clinical suspicion is crucial to prevent misdiagnosis and delays in initiating appropriate treatment, which is essential for optimizing the patient's outcome.