Primary cerebral sarcoid granuloma: the importance of definitive diagnosis in the high-risk patient population.
Sarcoidosis of the central nervous system has been variously reported in 5-15% of all sarcoid patients. However, presentation of sarcoidosis as an isolated 'intracranial tumor' is rare. A 35-year-old African-American woman presented with intractable headaches. Neuroimaging revealed a tumor that was suggestive of a glioma or meningioma or metastasis. The symptoms did not respond to steroids, and an open biopsy of the lesion revealed non-caseating granuloma. A thorough work-up for systemic sarcoidosis was negative. The patient remains symptom-free at a 2-year follow-up. Primary sarcoid granuloma of the brain is rare. Once systemic disease has been excluded, early tissue diagnosis is crucial. This is particularly relevant for patients in the high-risk population before considering empirical radiosurgery.
Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport, 1501 Kings Highway, PO Box 33932, Shreveport, LA 71130-3932, USA.
Prasad S S V
PS
Vannemreddy
Anil
A
Nanda
Praveen K
PK
Reddy
Enrique
E
Gonzalez
D000328:Adult; D001706:Biopsy; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000175:diagnosis; D006261:Headache / Q000209:etiology; D006801:Humans; D008579:Meningioma / Q000175:diagnosis; D016634:Radiosurgery; D012307:Risk Factors; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery