title: Cervical myelopathy from spinal sarcoidosis as the unexpected initial presentation for systemic sarcoidosis.
abstract: This is a case which highlights unique diagnostic challenges in the evaluation of a previously healthy patient presenting with a myelopathy initially most concerning for malignancy. However, timely recognition and nonoperative therapy of unexpected spinal sarcoidosis with corticosteroidal therapy was crucial in averting the sequelae of undiagnosed or misdiagnosed neurosarcoidosis, which can be devastating and life-threatening. Diagnosis is challenging due to significant similarities in clinical and roentgenographic findings of spinal sarcoidosis with infection, inflammation, and malignancy. Our case demonstrates that diagnosis of spinal sarcoidosis is especially elusive when it is the initial manifestation of sarcoidosis.
authors.affiliation: Department of Internal Medicine, Kaiser Permanente-Mid Atlantic, Camp Springs Medical Center, Temple Hills, MD 20748, USA. hientrinhnguyen@yahoo.com
authors.forename: Hien
authors.initials: H
authors.lastname: Nguyen
authors.forename: Connie
authors.initials: C
authors.lastname: Le
authors.forename: Hanh
authors.initials: H
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology; D003000:Clonidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003287:Contrast Media; D019786:Gadolinium DTPA; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006987:Hypesthesia / Q000188:drug therapy / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D018908:Muscle Weakness / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D003287:Contrast Media; D005938:Glucocorticoids; D009125:Muscle Relaxants, Central; C023754:tizanidine; D019786:Gadolinium DTPA; D003000:Clonidine; D011241:Prednisone