Neurosarcoidosis involving cervical nerve root with unusual MRI findings: a case report and systematic literature review

Background Neurosarcoidosis is rare, and among its manifestations, nerve root involvement has been reported in only a few cases. Therefore, magnetic resonance imaging (MRI) findings of neurosarcoidosis, particularly those involving nerve roots, are scarce in the literature. Methods We presented the...

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Bibliographic Details
Published in:European spine journal 2024-07, Vol.33 (7), p.2878-2885
Main Authors: Lee, Kyoung Yeon, Khil, Eun Kyung, Lee, Seun Ah, Lee, Joon Woo, Lee, Eugene
Format: Article
Language:English
Subjects:
Biopsy
Case Report
Cranial nerves
Enlargement
Lesions
Literature reviews
Lymph nodes
Lymphoma
Magnetic resonance imaging
Medicine
Medicine & Public Health
Nervous system diseases
Neuroimaging
Neurosurgery
Sarcoidosis
Spinal cord
Spinal nerves
Surgical Orthopedics
Systematic review
Trigeminal nerve
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Summary:Background Neurosarcoidosis is rare, and among its manifestations, nerve root involvement has been reported in only a few cases. Therefore, magnetic resonance imaging (MRI) findings of neurosarcoidosis, particularly those involving nerve roots, are scarce in the literature. Methods We presented the case of neurosarcoidosis involving cervical nerve roots and cranial nerves, alongside a systematic literature review. Results A 28-year-old female suddenly developed right facial numbness as well as left upper extremity and left hand pain. Initial brain and spine MRI showed a bulging mass of T2 iso-to-high signal intensity in the left Meckel’s cave/trigeminal nerve, as well as diffuse enlargement of the right C6 and C7 nerve roots. Follow-up MRI at 2 months revealed a reduction in the size of the initial lesion and the appearance of new similar lesions on the contralateral side (right Meckel’s cave, left C3–C8 nerve roots). In particular, the lesions involving the nerve roots demonstrated central enlargement along the nerve roots, without involvement of the adjacent spinal cord. All these lesions exhibited enhancement, leading to the differentiation between sarcoidosis and lymphoma. Sarcoidosis was subsequently confirmed through biopsy of a hilar lymph node. Conclusions This report presents a distinctive MRI feature of neurosarcoidosis involving spinal nerve roots, representing the first of its kind, and describes the evolution of MRI findings throughout the clinical course.
ISSN:0940-6719
1432-0932
1432-0932
DOI:10.1007/s00586-024-08159-z