Intradural extramedullary mass formation in spinal cord sarcoidosis: case report and literature review.

Abstract

A case of myelopathy caused by intradural extramedullary spinal cord sarcoidosis. To report a rare case of mass formation in spinal cord sarcoidosis and discuss the diagnostic approach and therapeutic management of this condition. Spinal cord sarcoidosis is a rare condition that is difficult to diagnose, and intradural extramedullary mass formation is even rarer. A 42-year-old woman first noticed numbness in her fingers, and these symptoms gradually spread to her hands and feet. MRI revealed an intradural extramedullary mass, as confirmed by an isointensity T1 and low-intensity T2 signal, and also enhanced by Gd-DTPA. The authors suspected the mass to be a meningioma and performed surgery to resect it. The mass was observed through the dura, and it was twined with the rootlet. After surgery, the patient experienced temporary paralysis of her right upper extremity, followed rapidly by almost complete neurologic recovery. Bilateral hilar lymphadenopathy was noted and this was diagnosed histologically as lung sarcoidosis. One year after surgery, a complete AV block occurred because of heart sarcoidosis and a pacemaker was inserted. Spinal cord sarcoidosis is rare disease and is difficult to diagnose, but when a mass is present in the spinal canal, it is important to remain open to the possibility of spinal cord sarcoidosis. Besides if it is diagnosed as spinal cord sarcoidosis, it is also important to remain systemic sarcoidosis before, during, and after surgery to check general conditions and to guide appropriate treatment.