| CASE REPORT |
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| Year : 2013 | Volume
: 4
| Issue : 2 | Page : 76-81 |
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Isolated spinal neurosarcoidosis: An enigmatic intramedullary spinal cord pathology-case report and review of the literature
Manish K Kasliwal1, Aparna Harbhajanka2, Sukriti Nag2, John E O'Toole1
1 Department of Neurosurgery, RUSH University Medical Center, Chicago, Illinois, USA
2 Department of Pathology, RUSH University Medical Center, Chicago, Illinois, USA
Correspondence Address:
Manish K Kasliwal
Department of Neurosurgery, Suite 855, RUSH University Medical Center, Chicago, Illinois - 60612
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-8237.128536
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Isolated spinal cord neurosarcoidosis (NS) in the absence of systemic disease or intracranial involvement is exceptionally rare. Adjunctive laboratory tests though useful may not be reliable and the absence of any pathognomonic radiological features makes the diagnosis difficult. As spinal cord NS may be a presenting feature of systemic sarcoidosis which may be occult on routine workup, 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) may be of value in unraveling this systemic involvement avoiding biopsying the spinal cord. A case of truly isolated NS is described with review of literature on this enigmatic pathology. Long segment intramedullary signal changes with focal parenchymal along with dural/meningeal enhancement in the absence of significant cervical stenosis in a young patient of northern European or African-American decent is very suggestive of NS and although may be presumably treated with steroids; there should be a low threshold for spinal cord biopsy especially in the absence of response to steroids to confirm isolated spinal cord NS in a patient with clinical neurological deterioration. |
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