A case of sarcoidosis, diagnosed from conjunctival tumor

Background: We present a rare case of sarcoidosis presenting with symptoms of conjunctival mass. Case Report: A 71-year-old female complained of dry-eye sensation. A nodular tumor about 15×3 mm was found in the lower fornix of each conjunctiva. Histopathologic examination showed that the tumors were sarcoid granulomas. No intraocular lesions were detected. Laboratory studies showed elevated levels of serum angiotensin-converting enzyme and lysozyme. Computed tomography showed remarkable enlargement of mediastinal lymph nodes. Bronchoalveolar lavage fluid showed an elevated CD4/CD8 ratio. Mantoux test results were negative for tuberculosis. Three months later, "snowball" vitreous opacity appeared and inflammatory cells were found in the anterior chamber, and we administered a sub-Tenon's injection of triamcinolone acetonide. Conclusion: Ophthalmologists should consider sarcoidosis in the differential diagnosis of conjunctival masses.