Neurosarcoidosis presenting with isolated intracranial mass lesion and communicating hydrocephalus

Neurocirugia (Astur : Engl Ed). 2020 Nov-Dec;31(6):306-312. doi: 10.1016/j.neucir.2019.10.004. Epub 2019 Dec 24.
[Article in English, Spanish]

Abstract

Isolated neurosarcoidosis is a very rare disease, which makes up 5-15% of sarcoidosis cases. Hydrocephalus is a rare clinical feature with a prevalence of 6% among these patients. Considering neurosarcoidosis in the differential diagnosis of a unique parenquimal mass lesion could help in the early identification of this disease. We report the case of a 27-year-old African man who developed with a sole intracranial mass lesion mimicking radiologically a glioma, which finally came out as an isolated neurosarcoidosis. There is a difficulty in diagnosis when isolated neurosarcoidosis appears. In addition, the low prevalence of the disease entails a not standardized medical treatment. Natural outcome is poor even when hydrocephalus is resolved. Multimodal treatments including complete pharmacological treatment do not seem to assure a better outcome in these patients until date.

Keywords: Brain tumor diagnosis; Diagnóstico de tumores cerebrales; Enfermedad granulomatosa; Glioma; Granulomatous disease; Hidrocefalia; Hydrocephalus; Isolated brain neurosarcoidosis; Neurosarcoidosis cerebral aislada; Sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Central Nervous System Diseases* / complications
  • Central Nervous System Diseases* / diagnosis
  • Humans
  • Hydrocephalus* / etiology
  • Magnetic Resonance Imaging
  • Male
  • Sarcoidosis* / complications
  • Sarcoidosis* / diagnosis

Supplementary concepts

  • Neurosarcoidosis