Diagnostic and therapeutic pitfalls in neurosarcoidosis.
(2009) Acta Neurologica Belgica — Vol. 109, n° 2, p. 91-99 (2009)
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- Abstract
- Neurosarcoidosis is a diagnostic challenge, especially in the absence of systemic involvement, even when cerebral biopsies show noncaseating granulomas. We report a patient with a pineal germinoma associated with a extensive peri- and intra- tumoural granulomatous reaction, who was first diagnosed as possible neurosarcoïdosis. A second patient was initially considered as suffering from Multiple Sclerosis. Brain biopsy showed typical granulomas and gallium scintigraphy revealed other locations of the disease. Unfortunately, he developed a severe, steroid-induced, epidural lipomatosis at the Th3-Th8 levels and died unexpectedly after surgical decompression. Granulomatous inflammation in a tissue obtained by biopsy from a midline lesion should be always considered for the differential diagnosis of germinoma. Corticosteroid-sparing immunosuppressant drugs should be used early in neurosarcoïdosis.
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Visée, H., Duprez, T., Godfraind, C., & Sindic, C. (2009). Diagnostic and therapeutic pitfalls in neurosarcoidosis. Acta Neurologica Belgica, 109(2), 91-99. https://hdl.handle.net/2078.5/34260 (Original work published 2009)