Solitary sarcoid granuloma of the cerebellopontine angle: a case report.
BACKGROUND
Sarcoidosis involves the nervous system about 5% of the time and usually manifests as a granulomatous inflammation of the basal meninges and hypothalamus. Cases which are strictly isolated to the central nervous system occur infrequently; rarely, they may present as an intracranial mass.


METHODS
We present the case of a solitary sarcoid granuloma at the cerebellopontine angle in a 42-year-old female who presented with headache, facial numbness, and hearing loss.


RESULTS
A suboccipital craniectomy was performed and the lesion was noted to be grossly adherent to the lower cranial nerves and skull base. The lesion was misdiagnosed as a meningioma with preoperative magnetic resonance imaging and intraoperative histology, and perhaps additional morbidity resulted.


CONCLUSIONS
We present this case in order to demonstrate the importance of differentiating these dural-based lesions and propose that cases of neurosarcoidosis presenting as a solitary granuloma be treated with surgical debulking and immunosuppression.
Elias
W J
WJ
Department of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Lanzino
G
G
Reitmeyer
M
M
Jane
J A
JA
D000328:Adult; D002526:Cerebellar Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery