Neurosarcoidosis masquerading as glioma of the optic chiasm in a child.
We present a case of sarcoidosis in a 14-year-old girl who presented with a short history of visual disturbance. Computed tomography and magnetic resonance imaging (MRI) demonstrated enlargement of the optic chiasm and prechiasmic optic nerves. Post-contrast MRI showed marginal enhancement of the affected areas of the optic pathways. A diagnosis of optic nerve glioma and arachnoid gliomatosis was made; surgical confirmation was not sought due to the risk to vision associated with biopsy. A rapid clinical deterioration led to repeat MRI which demonstrated extensive enhancing soft tissue throughout the basal cisterns with extension into the brain. Biopsy confirmed a diagnosis of sarcoidosis.
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Department of Neuroradiology, Manchester Royal Infirmary, UK.
McDermott
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Romanowski
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CA
Jackson
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A
D000293:Adolescent; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009897:Optic Chiasm; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012507:Sarcoidosis / Q000175:diagnosis*