Intramedullary neurosarcoidosis in the medulla oblongata: A case report

Tjokorda G.B. Mahadewa, Hiroshi Nakagawa, Takeya Watabe, Tatsushi Inoue

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE: We present a rare case of neurosarcoidosis mimicking an intramedullary tumor in the medulla oblongata. The features of the clinical presentation, magnetic resonance (MRI) appearances, and management strategy are discussed. CASE PRESENTATION: A 59-year-old man without evidence of systemic sarcoidosis was presented with a history of progressive numbness and deep sensation disturbance in bilateral lower extremities. MR imaging revealed an enhanced intra-axial mass lesion on the dorsal side of medulla. Under neurophysiological monitoring, tumor biopsy was performed. Pathologic evaluation revealed noncaseating granuloma composed of large epithelioid cells with multinucleated giant cells, suggesting sarcoidosis. Findings of comprehensive hematologic laboratory studies; cerebrospinal fluid examination; and examinations for bacteria, fungi, and acid fast bacilli were all negative. This mass lesion was diagnosed as medullary neurosarcoidosis, and then high-dose steroid therapy was tried. On follow-up, nearly complete resolution of the neurosarcoidosis on MRI was revealed. CONCLUSION: To our knowledge, this is the first reported case of neurosarcoidosis manifested in the medulla oblongata. A biopsy is sufficient for a diagnosis and high-dose steroid is recommended.

Original languageEnglish
Pages (from-to)283-287
Number of pages5
JournalSurgical Neurology
Volume61
Issue number3
DOIs
Publication statusPublished - 03-2004
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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