Diagnostic and therapeutic pitfalls in neurosarcoidosis.

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.

journal_name

Acta Neurol Belg

journal_title

Acta neurologica Belgica

authors

Visée H,Duprez TP,Godfraind C,Sindic CJ

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

91-9

issue

2

eissn

0300-9009

issn

2240-2993

journal_volume

109

pub_type

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