Sarcoidosis presenting as an intra- or extra-axial cranial mass: report of two cases.
Sarcoidosis may also present as an extra- or intra-axial mass involving the central nervous system. These lesions are sometimes operated upon, because a neoplasm is suspected. We report two cases of unusual tumour-like extra- and intra-axial sarcoidosis. The extra-axial mass was just medial to the jugular foramen. Its morphology and signal characteristics differed from the more common lesions in this area. The intra-axial mass was in the temporal lobe, with only minor leptomeningeal involvement. Extra-axial sarcoidosis can be confused with a meningioma because these lesions can give relatively low signal on T2-weighted images. Intra-axial masses are presumed to represent a propagation and fusion of multiple leptomeningeal granulomas through the Virchow-Robin spaces in the brain; this pattern can be sought on contrast-enhanced T1-weighted images.
Urbach
H
H
Department of Neuroradiology, University of Bonn, Germany.
Kristof
R
R
Zentner
J
J
Brechtelsbauer
D
D
Solymosi
L
L
Wolf
H K
HK
D000368:Aged; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012507:Sarcoidosis / Q000175:diagnosis*; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis; D013702:Temporal Lobe / Q000473:pathology