[Sphenocavernous localization of meningeal neurosarcoidosis. Apropos of a case and review of the literature].
The authors report on the case of a 32 year old woman treated with prednisone and diphenylsulfon for a multi-visceral sarcoidosis; headache and progressive oculomotor paralysis revealed an expansive lesion of the left cavernous sinus extending to the temporal fossa. C.T. scan, M.R.I., and angiographic data as well as the intra-operative findings evoked the diagnosis of meningioma. Pathological findings showed an epithelioid and gigantocellular granuloma without caseous necrosis, corresponding to a sarcoidosic lesion. After the operation, the increase of steroid doses was followed by a complete regression of the tumoral remnants, and total clinical recovery. In a patient having a previously diagnosed sarcoidosis with evidence of an intracranial tumor mimicking a meningioma, steroids should be first prescribed. Efficacy of steroids on sarcoid granulomas is often dramatic; surgical approach would be discussed in case of ineffective steroid therapy, of persisting questionnable diagnosis, and of tumoral threatening compression.
Nataf
F
F
Service de Neurochirurgie, Centre Hospitalier Ste Anne, Paris.
Devaux
B
B
Lamy
C
C
Fallet-Bianco
C
C
Roux
F X
FX
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002426:Cavernous Sinus; D002493:Central Nervous System Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000175:diagnosis*; D008578:Meninges / Q000000981:diagnostic imaging / Q000473:pathology*; D008579:Meningioma / Q000175:diagnosis*; D012507:Sarcoidosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones
Localisation sphéno-caverneuse de la neurosarcoïdose méningée. A propos d'un cas et revue de la littérature.