Case report: middle-aged woman from Ghana with unsteady gait and enlarging cerebellar mass

Neurosarcoidosis (NS) is an uncommon manifestation of systemic sarcoidosis, with a propensity for middle-agedwomen. Often discovered only at autopsy, rates of neurologic involvement (5%-10%) reported in the literature underscore a lack of sensitivity and specificity in current diagnostic methods. He...

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Bibliographic Details
Published in:Medicine (Baltimore) 2017-11, Vol.96 (45), p.e8516-e8516
Main Authors: Bajantri, Bharat, Venkatram, Sindhaghatta, Niazi, Masooma, Singh, Tushi, Diaz-Fuentes, Gilda
Format: Article
Language:English
Subjects:
Central Nervous System Diseases - complications
Central Nervous System Diseases - diagnosis
Clinical Case Report
Female
Gait Disorders, Neurologic - etiology
Ghana
Humans
Middle Aged
Sarcoidosis - complications
Sarcoidosis - diagnosis
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Summary:Neurosarcoidosis (NS) is an uncommon manifestation of systemic sarcoidosis, with a propensity for middle-agedwomen. Often discovered only at autopsy, rates of neurologic involvement (5%-10%) reported in the literature underscore a lack of sensitivity and specificity in current diagnostic methods. Herein, we describe a 53-year-old woman who presented with gait imbalance and distal extremity muscular weakness. She was known to harbor a brain mass (4 years in duration) that was monitored and recently seemed to enlarge. A subsequent brain biopsy showed necrotizing granulomatous inflammation suggestive of NS. However, no clinical or radiologic evidence of activity was found in other organs. Ultimately, endo and transbronchial biopsies were performed, providing histologic confirmation of systemic sarcoidosis. This approach is advised in all instances of suspected NS where systemic involvement is in question.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000008516